ABSTRACT
A patient is described with acute myocardial infarction complicated by rupture of a papillary muscle. A surprise finding at necropsy was a fragment of necrotic myocardium, similar to that at the site of papillary muscle rupture, in one coronary artery. Myocardial embolism to a coronary artery has not been described previously to our knowledge. Although they are infrequent, emboli to coronary arteries usually consist of fibrin and platelets. Other dislodged materials in coronary arteries have included calcific debris, clumps of neoplastic cells, suture and other foreign materials, and colonies of microorganisms. The usual consequence of coronary embolism is acute myocardial infarction. Therefore, it appears reasonable to conclude that the embolus to the right coronary artery resulted from dislodgement of myocardium during or shortly following rupture of the left ventricular papillary muscle.
