'Angina' of the papillary muscle: an overlooked but reversible etiology of mitral regurgitation.

INTRODUCTION In the absence of acute myocardial infarction (MI), ischemic papillary muscle dysfunction (PMD) is a rare complication of coronary artery disease. Dynamic PMD results in intermittent mitral regurgitation (MR). We present a successfully-treated case of recurrent pulmonary edema due to dynamic PMD secondary to chronic coronary heart disease involving the mitral apparatus. A pathophysiologic similarity could be drawn with intermittent angina pectoris (“angina equivalent”).