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Is it septic or cardiogenic shock? Papillary muscle rupture masquerading as sepsis
Author(s) -
Mukherjee Ashes,
Ravindranath Syamnadh
Publication year - 2019
Publication title -
australasian journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
eISSN - 2205-0140
pISSN - 1836-6864
DOI - 10.1002/ajum.12117
Subject(s) - medicine , cardiogenic shock , septic shock , presentation (obstetrics) , emergency department , sepsis , shock (circulatory) , complication , myocardial infarction , percutaneous coronary intervention , intensive care medicine , general surgery , medical emergency , radiology , surgery , cardiology , psychiatry
Rupture of a papillary muscle is an extremely rare but catastrophic complication of an acute myocardial infarction. Survival is time dependent on the expedition of the patient from the area of presentation to the operating theatre for surgery. Diagnosis in the ED is possible within minutes of presentation if an echo is performed by an emergency physician skilled in echocardiography, as we demonstrate. Case presentation We present a case of a 59 years male self‐presenting to the emergency department with undifferentiated shock. An EP performed echo directed us towards the rare but correct diagnosis. He was then transferred for percutaneous coronary intervention and surgical management. Conclusion Often in the past a diagnosis made on coronary care units or post‐mortem, we believe this diagnosis in the future will be made more frequently at the bedside in emergency departments across the world as emergency physicians continue to incorporate echocardiography as a skill in their diagnostic armoury.