The two most important MI complications that occur within a 2-5 day span are papillary muscle rupture and interventricular septum ruture.

Papillary muscle rupture leads to severe mitral regurgitation, heard as a systolic murmur at the apex.

This patient has some characteristics of myocardial infarction including a sudden onset of severe “crushing” substernal chest pain that radiates to the left arm, shortness of breath, and jugular venous distention (JVD). Complications of myocardial infarction include cardiac rupture which is seen in this patient. The effects vary with the site of rupture; from the patient’s mitral insufficiency {i.e. systolic murmur at the apex} we can see that this is a rupture at the papillary muscle.

Resource Kaplan Pathology Page 94-95