A Case of Transient Mitral Regurgitation: Not Everything Is Always What It Seems

Not Your “Run-of-the-Mill” Mitral Regurgitation

“…Unfortunately, he succumbed to infectious complications postoperatively. 9 This case highlights the importance of recognizing this transient form of MR and keeping it in mind when determining causes of secondary MR.…”

“…In this issue of JCVA, Arias-Godinez and colleagues present an intriguing case of mitral regurgitation as an E-Challenge. 9 After a diagnosis of severe functional MR that was initially suspected to be ischemic in origin, the patient was treated with distal left circumflex stenting. However, after treatment of his coronary disease, repeat echocardiographic evaluation again demonstrated normal MV leaflets with continued MR that ranged in severity from mild to severe within minutes, similar to what was noted before stenting.…”

“…The current algorithmic approach to echocardiography assessment of any MV pathology takes into account several quantitative and qualitative factors, but does not always emphasize the value of repeat imaging. While the changing severity of MR in eclipsed MR is often seen during a single imaging study, as was shown in the case presented by Arias-Godinez and colleagues, repeat assessment by echocardiography may be warranted to appreciate the transient nature of the MR. 9 Along with the transient quality (typically lasting less than 30 minutes), other hallmarks of eclipsed MR would demonstrate severe, functional MR that is reversible. [11][12][13] When other "run-of-the-mill" causes of secondary MR do not apply, eclipsed MR should be considered if these criteria have been met.…”

“…[11][12][13] When other "run-of-the-mill" causes of secondary MR do not apply, eclipsed MR should be considered if these criteria have been met. Given the limited reporting of eclipsed MR, cases such as the E-challenge presented in this issue are welcome to further allow clinicians to appreciate, and potentially diagnose, this rare cause of MR. 9…”