Background: A 67-year-old man was admitted to a coronary care unit for non-ST-segment elevation myocardial infarction with complicating acute heart failure. Severe mitral regurgitation was detected by echocardiography at presentation. Repeat echocardiography carried out during another ischemic episode revealed a marked reduction in the patient's mitral regurgitation that was related to decreased apical traction of the valve leaflets.
Investigations: Physical examination, electrocardiography, laboratory tests, coronary angiography, chest radiography, echocardiography.
Diagnosis: Mitral regurgitation associated with acute coronary syndrome.
Management: Early revascularization by percutaneous coronary intervention, supported by pharmacological therapy to decrease left ventricular filling pressure.