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

Figures

• 

  Figure 1.. The electrocardiogram obtained in the emergency department. Heart rate: 60 beats per minute, atrial pacing rhythm. ST elevation was observed in leads aVL and aVR, and ST depression was observed in leads II, III, aVF, and V4-6.

• 

  Figure 2.. (A) Color doppler imaging by transthoracic echocardiography before percutaneous coronary intervention. Severe mitral valve regurgitation (MR) was detected. (B) Image on the fourth day; MR was significantly improved.

• 

  Figure 3.. (A) Coronary angiography revealed total occlusion of the distal right coronary artery (white arrow). (B) Note 99% stenosis in the left circumflex artery (black arrow) and 90% stenosis of the mid-left anterior descending artery (red arrow). (C) (D) We performed stent implantation in #11 (black arrow) and #6 (red arrow).

• 

  Figure 4.. (A) Transesophageal echocardiography showed severely tented mitral valve leaflets. The mitral valve leaflet tenting height was 12 mm. (B) Color doppler showed severe mitral valve regurgitation due to valve coaptation failure.

• 

  Figure 5.. (A) (B) Transthoracic echocardiography showed that the tenting height had decreased from 15 to 9 mm after revascularization. (C) (D) Similarly, the papillary muscle distance at the systolic interval shrank decreased from 22 to 19 mm.