cardiogenic shock and anterior papillary muscle rupture caused by blood supply to diagonal artery

acute mitral regurgitation accounts for 9% cases of cardiogenic shock following myocardial infarction and results from papillary muscle infarction. this complication occurs early following myocardial infarction. the etiologies of this devastating complication include left ventricular failure, right ventricular failure and acute mitral regurgitation that mitral regurgitation usually results from papillary muscle rupture. we reported a 41 year old male with first diagonal branch stenosis and dominant left circumflex and complete transaction of anterolateral papillary muscle that had not been reported in literature.