The great masquerader: Papillary muscle rupture, a diagnosis forgotten?

Acute papillary muscle rupture (PMR) often results in acute, torrential mitral regurgitation and florid pulmonary edema. This catastrophic consequence of a subacute presentation of myocardial infarction is associated with a high mortality rate if not identified quickly. The incidence of PMR has decreased in the era of early percutaneous interventions for acute coronary syndromes. However, the importance of prompt recognition and intervention for this condition is paramount. We present a classic case of PMR and the associated hemodynamics, diagnosis and therapeutic management. This case serves as a guide in unmasking this fatal condition.   Key words: Papillary muscle rupture (PMR), diagnosis, myocardial infarction, pulmonary edema.