An unexpected cause of postoperative right heart failure

Cardiac injury from cardiopulmonary resuscitation is a rare phenomenon. A 72-year-old women following elective mitral valve repair suffered cardiac arrest (pulseless electrical activity). Post-resuscitation transoesophageal echocardiogram (Fig. 1) revealed a rupture of the anterior papillary muscle of the tricuspid valve (Fig. 2). She underwent emergency tricuspid valve replacement with a successful outcome.