The Syndrome of Papillary Muscle Dysfunction

Abstract

Coordinated contraction of the papillary muscles during left ventricular contraction appears to be a delicately balanced mechanism in maintaining mitral valve competence. Lesions of the papillary muscles may alter this balance resulting in the production of mitral insufficiency. The murmur associated with this particular lesion appears to have distinctive characteristics. The most common cause of mechanical dysfunction of the papillary muscle is coronary heart disease. Infarction of the anterolateral papillary muscle may be suspected from the electrocardiogram. Suggestive features here involve primarily changes in junction J, the ST-T interval, the T-V segment and the U wave. The description of this syndrome of papillary muscle dysfunction in 11 patients forms the basis of the present report.