Acute Ischemic Mitral Regurgitation Treated by Percutaneous Coronary Intervention after an Accurate Diagnosis on Transesophageal Echocardiography

• Published in: Internal Medicine Vol. 60; no. 9; pp. 1417 - 1421
• Main Authors: Miyazaki, Ryoichi, Watanabe, Keita, Kaneko, Masakazu, Nagamine, Sho, Hara, Nobuhiro, Nakamura, Tomofumi, Nagata, Yasutoshi, Nozato, Toshihiro, Ashikaga, Takashi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.05.2021; Japan Science and Technology Agency
• Subjects: acute myocardial infarction; Angiography; Angioplasty; between papillary muscles diameter; Case Report; Catheters; Congestive heart failure; Echocardiography; Infarction; Internal medicine; Ischemia; ischemic mitral valve regurgitation; Mitral valve; Muscles; Regurgitation; Stenosis; Stents; tenting height; tethering; transesophageal echocardiography; Ventricle; between papillary muscles diameter; ischemic mitral valve regurgitation; tethering; transesophageal echocardiography; tenting height; acute myocardial infarction
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.5502-20

An 80-year-old woman with acute posterolateralmyocardial infarction, cardiogenic shock, and acute heart failure was admitted to our hospital. Transthoracic echocardiography (TTE) showed dysfunction of the left ventricular inferolateral wall motion and severe mitral valve regurgitation (MR). Emergency coronary angiography revealed triple-vessel stenosis. We performed transesophageal echocardiography in the catheter room to diagnose the cause of MR. Severe tenting of the mitral valve and no rupture of the papillary muscles were revealed. We considered ischemic MR likely to improve with revascularization and performed percutaneous coronary intervention. Subsequently, the patient's circulatory dynamics rapidly stabilized, and MR was significantly improved on follow-up TTE.