Echocardiogram in Myocardial Infarction

Aka: Echocardiogram in Myocardial Infarction, Echocardiogram in Acute MI

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II. Advantages

  1. Noninvasive
  2. Quick
  3. Portable
  4. Inexpensive

III. Disadvantages

  1. Operator dependent

IV. Indications

  1. Diagnosis
    1. Ongoing Chest Pain
    2. Transmural Myocardial Infarction
    3. No prior Myocardial Infarction
  2. Prognosis
    1. Baseline for development of complications
    2. Potential discharge from Critical Care Unit
  3. Monitoring
    1. Response to therapeutic interventions

V. Wall Motion Abnormalities

  1. Early detection by Echocardiogram
  2. Precedes Electrocardiogram changes
  3. Less accurate in patient without ongoing Chest Pain
  4. Difficult to interpret if prior Myocardial Infarction
  5. Sensitivity
    1. Transmural Myocardial Infarction: 90%
    2. Subendocardial Myocardial Infarction: 60-80%

VI. Complication Detection

  1. Aneurysm
  2. Ventricular Septal Defect (VSD)
  3. Papillary Muscle rupture with regurgitation
  4. Myocardial Rupture
  5. Pericardial Effusion
  6. Left Ventricle thrombus formation
  7. Infarct extension
  8. Right Ventricle infarction

VII. References

  1. Zile (2002) Circulation 105:1387-93 [PubMed]

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