ST elevation myocardial infarction echocardiography: Difference between revisions
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* [[Left ventricular aneurysm]] | * [[Left ventricular aneurysm]] | ||
* [[ST elevation myocardial infarction natural history and complications#Pseudoaneurysm|Left ventricular pseudoaneurysm]] | * [[ST elevation myocardial infarction natural history and complications#Pseudoaneurysm|Left ventricular pseudoaneurysm]] | ||
==Role of Echocardiography in Risk Assessment After STEMI== | |||
According to 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction, left ventricular ejection fraction should be assessed in all patients following [[MI]] (Class I, level of evidence C).<ref name="pmid23247303">{{cite journal| author=O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA et al.| title=2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=Circulation | year= 2013 | volume= 127 | issue= 4 | pages= 529-55 | pmid=23247303 | doi=10.1161/CIR.0b013e3182742c84 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23247303 }} </ref> | |||
==References== | ==References== | ||
Revision as of 20:08, 8 May 2014
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Overview
Echocardiography can be quite useful in identifying complications of ST elevation MI. If the diagnosis of ST elevation MI is clear, reperfusion should not be delayed pending the performance of an echocardiogram.
Role of Echocardiography in Diagnosing MI
- Echocardiography is not a routine test for the diagnosis of myocardial infarction (MI) since the diagnosis relies mainly on the ECG findings and elevation in cardiac enzymes. However, it is appropriate to do an echocardiography when a patient presents with acute chest pain suspicious of MI and the ECG is not diagnostic. In addition, echocardiography can also be used for the diagnosis of MI when the results of the ECG and cardiac enzymes are suggestive of MI in the absence of chest pain.[1]
- Regional wall motion abnormality (RWMA) is an echocardiographic sign suggestive of ischemia and in. However, despite its high sensitivity, RWMA is not highly specific for MI.[2]
Role of Echocardiography in Detecting Post MI Complications
Echocardiography is an appropriate test for the complications of MI, including:[1]
- Mitral regurgitation
- Ventricular septal defect
- Free wall rupture
- Cardiac tamponade
- Shock
- Right ventricular involvement
- Left ventricular thrombus
- Pericardial effusion
- Left ventricular aneurysm
- Left ventricular pseudoaneurysm
Role of Echocardiography in Risk Assessment After STEMI
According to 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction, left ventricular ejection fraction should be assessed in all patients following MI (Class I, level of evidence C).[3]
References
- ↑ 1.0 1.1 American College of Cardiology Foundation Appropriate Use Criteria Task Force. American Society of Echocardiography. American Heart Association. American Society of Nuclear Cardiology. Heart Failure Society of America. Heart Rhythm Society; et al. (2011). "ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance American College of Chest Physicians". J Am Soc Echocardiogr. 24 (3): 229–67. doi:10.1016/j.echo.2010.12.008. PMID 21338862.
- ↑ Sabia P, Afrookteh A, Touchstone DA, Keller MW, Esquivel L, Kaul S (1991). "Value of regional wall motion abnormality in the emergency room diagnosis of acute myocardial infarction. A prospective study using two-dimensional echocardiography". Circulation. 84 (3 Suppl): I85–92. PMID 1884510.
- ↑ O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA; et al. (2013). "2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 127 (4): 529–55. doi:10.1161/CIR.0b013e3182742c84. PMID 23247303.