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.
