| Summary points: | A 48-year-old smoker with hypertension and hypercholesterolaemia presents with cardiogenic shock, pyrexia, a high white cell count, and elevated serum troponin T level. This case report describes the findings from physical examination, cardiac catheterisation, angiogram, and echocardiography, blood cultures, and histological studies, and outcome. The authors discuss the mechanisms that can result in isolated rupture of the papillary muscle and prognosis. |