Clinical Practice and Cases in Emergency Medicine

We report a case of a 52-year-old man who presented to the emergency department (ED) in extremis(hypotensive with an altered sensorium) with subsequent cardiac arrest after a motor vehicle collision.The initial trauma evaluation did not reveal a source of the hemodynamic compromise. A point-of-careultrasound revealed severe mitral regurgitation secondary to an anterolateral papillary muscle rupture.Patient underwent successful emergent mitral valve replacement after initial resuscitative efforts andintraaortic balloon pump placement.