A case of mitral papillary muscle rupture due to blunt chest traumaAliRahmiBakiler,S.AyvazAydodu,SedaErien,AyeYenign,YkselAtay, DepartmentsofPediatrics,AdnanMenderesUniversityFacultyofMedicine,Aydn,andCardiovascularSurgery,Ege UniversityFacultyofMedicine,zmir,TurkeySUMMARY:BakilerAR,AydoduSA,ErienS,YenignA,AtayY.Acase ofmitralpapillarymuscleruptureduetobluntchesttrauma.TurkJPediatr 2011;53:97-99.Mitralregurgitationduetopapillarymuscleruptureafterbluntchesttrauma isuncommon.Suddenonsetseveremitralregurgitationmayleadtodeath duetoheartfailureifsurgicalrepairisdelayed.Apreviouslyhealthy12-year-oldgirlunderwentsplenectomyandchesttube insertion for pneumothorax after a traffic accident in a vehicle 15 days before. Shewasdischargedfromthehospitalafteranine-dayfollow-up.Shewas presented to our hospital due to respiratory distress. On physical examination, an apical holosystolic murmur radiating to the axillary region was recognized. Transthoracicechocardiogramshowedseveremitralregurgitationwithfreely movingposteriormitralchordaeandprolapseoftheposteriormitralvalve leaflet.Shereceivedreimplantationofthecompleterupturedposteromedial papillary muscle of the mitral valve. Her medical condition improved after the operation.Onthepostoperativeechocardiogram,theleftventricularsystolic functionwasnormalwithnomitralregurgitation. Keywords:bluntchesttrauma,papillarymusclerupture,mitralregurgitation.Blunttraumaistheleadingcauseofcardiac traumainchildhood1.Motorvehicleaccidents are the major cause of blunt trauma, accounting for81%ofcases2.Bluntcardiacinjuriesare oftenunsuspectedinjuriesassociatedwith multiplesystemtrauma3. CaseReportA 12-year-old girl was presented to our hospital duetoshortnessofbreath,palpitationand chestpain.Itwasreportedthatshehadbeen involvedinatrafficaccidentinavehicle15 daysbefore,andunderwentsplenectomyand chesttubeinsertionforleftpneumothorax duetoribfractureinanotherhospital.After ninedaysoffollow-up,shewasdischarged home.Duetodeteriorationinhermedical condition,shewasbroughtandadmittedto ourhospital. Hermedicalhistorywasunremarkable.Her generalconditionwaspoor,withaheart rateof116/bpm,bloodpressureof70/50 mmHg,temperatureof36.8C,respiratory frequencyof36/min,andSpO2of85%.On physicalexamination,intercostalretractions andbilaterallycrepitantralesinbasallung regionsandaholosystolicmurmurradiating totheaxillawererecognized. Laborat or yt est sshowed: er yt hrocyt e sedimentation rate 24 mm/h, C-reactive protein 7mg/L,creatinephosphokinase(CPK)110 mg/dl,CPK-MB3.4mg/dl,andtroponinI