Images in Cardiovascular Medicine Severe Ischemic Mitral Regurgitation Despite Normally Contracting Subpapillary Myocardium

It is caused by left ventricle (LV) remodeling andsubsequent papillary muscle (PM) displacement, with sec-ondary mitral leaflet tethering. It can be seen classically inglobal LV dilatation and dysfunction or with more localremodeling involving the posterior PM and inferoposteriorbasal to mid LV wall.