A case series of patients with early diastolic mitral regurgitation and left ventricular aneurysm

This study presents patients with left ventricular aneurysm after anterior myocardial infarction showing early diastolic mitral regurgitation. This study was a case series (n=4) of patients with concurrent left ventricular aneurysm and early diastolic mitral regurgitation who died within six months following echocardiography. All the four patients showed low left ventricle ejection fraction values <33%, died of heart failure within six months following echocardiography. Incidentally, trans-mitral flow in all the four patients showed low-velocity E-waves with lower velocities (two showed no E-wave), as well as an end-diastolic A-wave with higher velocities than the E-wave. An impaired relaxation pattern was observed, despite the high pulmonary arterial wedge pressure >25 mm Hg and heart rate <90 bpm. These cases are first report of early-diastolic mitral regurgitation in left ventricular aneurysm with low left ventricle ejection fraction, which may be due to relatively high pressure in the left ventricle. In such cases the trans-mitral flow pattern in such cases could not predict pulmonary arterial wedge pressure.