Somebody in tachycardia and pulmonary edema for days will probably have up to MI-level trops.In my mind decompensated heart failure and CS means no anesthesia unless for a lifesaving procedure.
If she has functional MR she needs optimization and likely MCS. I like Impella here, given the pulmonary edema (feel like it gives better offloading than an IABP).
If it's pap rupture she needs surgery. This seems pretty unlikely with 3 TTEs and no clear rupture. Did she get a trop?
Cardiac CT might give a quick answer to primary vs secondary MR.