Volume 6 Supplement 4
Mitral regurgitation secondary to ventricular remodelling post myocardial infarction – an echocardiographic study
© Thakur and Ionac; licensee BioMed Central Ltd. 2012
Published: 9 July 2012
To evaluate the incidence and mechanism of mitral regurgitation [MR] as a complication in the evolution of myocardial infarction [MI]. Patient population: 95 patients diagnosed on the basis of clinical, electrocardiographic and coronary-angiographic data with coronary artery disease [CAD] with a history of MI with haemodynamically significant MR (>/=grade II).
• All patients were treated in accordance with standard therapy for CAD and heart failure
• 56 Patients with PTCA of the obstructed coronary artery
• 28 Patients treated with CABG out of these 19 patients with mitral valvuloplasty
Criteria for exclusion from the study: patients with organic MR (mitral valve modified as a result of rheumatic fever, infectious endocarditis or degeneration) or with myxomatous mitral valve prolapse.
Transthoracic echocardiography [TTE] for all patients and transoesophageal echocardiography for 75 patients.
Sixty eight patients had grade II MR and twenty seven grade III MR. The aetiology of MR was:
• Papillary muscle rupture – 1 patient
• Papillary muscle ischaemia (inferior or posterior MI) – 15 patients
• Dilatation and remodeling of left ventricle [LV] – 58 patients (13 out of these 58 patients had LV aneurysms)
• Mixed mechanism (papillary muscle ischaemia and LV dilatation) – 21 patients
MR appears frequently in the evolution of patients with MI, even in patients subjected to a standard line of treatment. Echocardiography is a very important tool for the evaluation of severity and more importantly, that of aetiology. Understanding of the mechanism of MR offers the possibility to find a correct treatment option and where necessary, an optimal surgical intervention.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.