[A case of acute postinfarction mitral insufficiency and cardiogenic shock caused by total rupture of a papillary muscle].

A 61-year-old male in cardiogenic shock was transferred to our hospital with an intra-aortic balloon pumping (IABP). He had had acute posterior myocardial infarction previous day. He had developed progressively increasing dyspnea and physical signs of severe congestive failure. On admission, his blood pressure was 60 mmHg even with IABP. He was anuric with a high blood urea nitrogen and serum creatinine level. An echocardiogram demonstrated a rupture of a posterior papillary muscle and massive mitral insufficiency. His deteriorating condition did not allow us to perform cardiac catheterization. He underwent an emergency operation. Total rupture of a posterior papillary muscle was confirmed. Mitral valve replacement with a SJM prosthetic valve was performed. A postoperative course was uneventful.