Variante de la anatomía de los músculos papilares como causa de insuficiencia mitral. Un caso de válvula mitral asimétrica en paracaídas-like

INTRODUCTION: The parachute-like mitral valve is a congenital anomaly characterized by an asymmetric arrangement of the papillary muscles, with cardiac imaging being the procedure of choice both for anatomical diagnosis and for functional assessment of this type of structural anomaly. CLINICAL CASE: Patient with hemodynamic decompensation in which a parachute-like mitral valve disease was diagnosed incidentally. Image findings by transthoracic echocardiography and magnetic resonance revealed the presence of 2 papillary muscles, both with apical lateral segment insertion, confirming an asymmetric mitral valve similar to its parachute morphology. DISCUSSION: The parachute mitral valve is an uncommon congenital anomaly constituting the presence of two papillary muscles, one of them being more elongated and adhering to the mitral leaflet in a contiguous way, showing in some cases small associated tendinous chords. It can present a benign evolution being a chance finding or associated with valvular hemodynamic repercussion as the case presented. CONCLUSION: The parachute-like mitral valve is a congenital anomaly characterized by an asymmetric arrangement of the papillary muscles, its evolution being highly variable, being able to go unnoticed or significantly affecting valve mechanics.