Transient ST-segment elevation occurring in the context of percutaneous cardiac interventions has not been fully characterized. We present a case of an inferior ST-segment elevation associated with angina and hypotension following percutaneous mitral valvuloplasty. Coronary angiography during ST elevation found no abnormalities and no myocardial necrosis was documented. Thus, as the Inoue balloon had been reinflated and overinflated, we suggest that mechanical myocardial compression might be responsible for the transmural transient ischemia observed in some cardiac percutaneous procedures involving balloons or closure devices.
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