1Department of Cardiology, Kobe General Hospital, 2Department of Pediatrics, Kobe General Hospital, 3Department of Cardiology, Chikamori Hospital
Aneurysm of the left ventricle, Rupture of the papillary muscle, Traumatic heart disease
Transthoracic and transesophageal echocardiography was used to examine a 14-year-old girl with severe mitral regurgitation secondary to traumatic papillary muscle rupture and left ventricular septal aneurysm. The girl had been referred by her physician because of severe pulmonary edema. A transthoracic two-dimensional echocardiogram showed a large dissection between the myocardium and the anterior papillary muscle, while the middle scallop of the posterior leaflet attached to the anterior papillary muscle was shown to be prolapsing into the left atrium during systole. An eccentric severe regurgitant jet that produced an acceleration signal in the left ventricular chamber was apparent on color flow Doppler echocardiography. Furthermore, transesophageal echocardiography revealed an interventricular septal aneurysm. These abnormalities were confirmed on surgery. We found transthoracic echocardiography used in combination with transesophageal echocardiography to be helpful in the diagnosis of traumatic papillary muscle rupture and left ventricular aneurysm.