Marked attenuation of mitral regurgitation by stent implantation: a patient with unstable angina.
A 69-year-old woman was admitted because of increase of chest pain and dyspnea. Systolic murmur of Levine III/VI was heard. Electrocardiography showed ST depression caused by ischemia. Echocardiography revealed severe mitral regurgitation (MR) and inferoposterior hypokinetic wall motion. Left ventriculography revealed the presence of MR (II/IV). Coronary angiography showed severe organic stenosis of the right coronary artery. Based on these findings, the diagnosis was severe papillary muscle dysfunction caused by unstable angina. The lesion of the right coronary artery was successfully stented with a Palmaz-Schatz stent. During balloon inflation, the v wave of the pulmonary capillary pressure curve was greatly elevated. After the stent implantation, ST depression was normalized and MR improved dramatically. Therefore, we suppose that acute MR was induced by temporary papillary muscle dysfunction, and could be relieved with coronary angioplasty.
Second Department of Internal Medicine, Ehime University School of Medicine.
T
T
Ohtsuka
M
M
Hamada
K
K
Kodama
S
S
Ikeda
H
H
Hashida
T
T
Kuwahara
Y
Y
Hara
Y
Y
Shigematsu
K
K
Hiwada
D000368:Aged; D000789:Angina, Unstable / Q000150:complications* / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D015607:Stents