Ischemic reversible mitral regurgitation in coronary artery disease

Papillary muscles have an important role in function of mitral valve. Whereas infarction or ischemia in these muscles, mitral valve dysfunction appear and in case of rupturing in papillary muscles acute sever dyspnea would be it’s presentation requiring emergent surgical action. Though mitral valve dysfunction due to ischemia could be presented as reversible mitral regurgitation. We reported a 52-year-old man presented with progressive dyspnea and chest pain for the last 2 days. He of course experienced an acute chest pain attack 2 days ago. Initial work up revealed ST-T changes due to recent MI attack with positive troponin I serum level. Echocardiography during chest pain periods showed LVEF=30% accompanied by sever Mitral Regurgitation (MR). After initial treatment for ischemia, MR and heart failure resolved and also patient’s symptoms relief. Then echocardiography showed LVEF+50% and mild MR. Coronary angiography revealed 95% stenosis in mid part of RCA, so the patient underwent coronary angioplasty. In these cases with papillary muscle ischemia, reperfusion or lowering cardiac demand can eliminate ischemic mitral valve regurgitation.

Keywords:

Mitral regurgitation , CAD , ischemia