Ischemic mitral regurgitation (IMR) is one of the most challenging complications of acute myocardial infarction (AMI) and chronic coronary artery disease (CAD). The presence of IMR, irrespective of severity significantly have a negative impact on the short and long-term outcomes of patients with AMI and CAD. Nearly 25% of patients with AMI without congestive heart failure (CHF) develop IMR and this number approaches 50% when CHF is present.