CASE REPORT Obstructive intramural coronary amyloidosis and papillary muscle rupture

Mitral papillary muscle rupture is usually caused by ischaemia as a complication of myocardial infarction. In a 76 year old patient with no significant disease or major cardiovascular risk factors, papillary muscle rupture was caused by obstructive intramural coronary amyloidosis, an unusual cause. The most frequent cause of acute mitral regurgitation isischaemic papillary muscle dysfunction or rupture com-plicating acute inferior myocardial infarction. Other causes described in the literature are infectious and traumatic. We report an unusual cause of papillary muscle rupture successfully operated on. CASE REPORT A 76 year old patient with no significant disease and no major cardiovascular risk factors was admitted urgently to a second-ary hospital for acute pulmonary oedema and cardiogenic shock. Endotracheal intubation and inotropic support wer