Direct insertion of papillary muscle into mitral valve leaflets in a healthy patient without hypertrophic cardiomyopathy.

We present the case of a healthy young woman that was evaluated before participation in amateur sports. A systolic and diastolic murmur was heard during the physical examination. Two-dimensional echocardiography was performed, and a direct insertion of the posteromedial papillary muscle into the mitral valve leaflets was found.