[Echocardiography in acute coronary syndrome]
1Zavod za bolesti srca i krvnih zila, Klinika za unutarnje bolesti, Klinicka bolnica Dubrava, Avenija Gojka Suska 6 10040 Zagreb, Hrvatska. jvincelj@kbd.hr
Insights
Echocardiography is a valuable tool for diagnosing acute coronary syndrome (ACS), identifying complications, and assessing myocardial damage. This non-invasive method aids in patient management and evaluating treatment effectiveness.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Acute coronary syndrome (ACS) requires prompt and accurate diagnosis.
- Echocardiography offers a non-invasive approach to assess cardiac function and structure.
Purpose of the Study:
- To evaluate the diagnostic and clinical utility of echocardiography in patients with ACS.
- To determine the role of echocardiography in identifying complications and assessing myocardial status.
Main Methods:
- Retrospective analysis of clinical, electrocardiographic, laboratory, and echocardiographic data from 46 ACS patients.
- Echocardiography performed using ATL 3000 HDI system.
Main Results:
- Wall motion abnormalities detected in 83% of patients.
- Impaired left ventricular (LV) ejection fraction in 30% and LV diastolic dysfunction in 43%.
- Echocardiography identified rare complications like LV thrombus and aortic dissection.
Conclusions:
- Echocardiography possesses significant diagnostic and prognostic value in ACS.
- It effectively evaluates myocardial damage, dysfunction, and detects acute complications.
- Advanced echocardiographic techniques enhance ACS diagnosis and reperfusion therapy assessment.
Aim:
The aim is to report on diagnostic and clinical role of echocardiography in acute coronary syndrome (ACS).
Patients And Methods:
Clinical, electrocardiographic, laboratory and echocardiographic data of 46 patients (26 men and 20 women), age range 38-82 (mean age 65 +/- 12.8) years admitted to hospital for ACS, were retrospectively analyzed. Echocardiography was performed with a ATL 3000 HDI (Advanced Technology Laboratories, Bothell, MA, USA.
Results:
Wall motion abnormalities were detected in 38 (83%), impaired global left ventricular (LV) ejection fraction (50%) in 14 (30%), LV diastolic dysfunction in 20 (43%) patients, and LV thrombus, acute thoracic aortic dissection, and rupture of interventricular septum with left to right shunt in 1 (2%) patient each.
Discussion And Conclusions:
Echocardiography has a diagnostic and prognostic value, and detects complications in ACS. Echocardiography can evaluate damaged myocardium and myocardium which is not involved with the acute ischemia. Assessment of global and segmental wall motion abnormalities, diastolic dysfunction and LV ejection fraction measurements are of great importance. New echocardiographic methods such as stress echocardiography and myocardial contrast echocardiography proved myocardial perfusion imaging at the microcirculation level, and contribute to an accurate diagnosis of ACS and better evaluation of reperfusion therapy. The use of echocardiography in the emergency room and coronary care unit as a nonivasive and inexpensive method in comparison with other established methods makes it highly useful in the management of ACS patients.
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