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

An 80-year-old woman with acute posterolateral myocardial 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.