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Echocardiography in the evaluation of patients in chest pain units

William R Lewis1

  • 1william.lewis@ucdmc.ucdavis.edu

Cardiology Clinics
|November 10, 2005
PubMed

Insights

Echocardiography detects cardiac wall motion abnormalities, an early sign of myocardial ischemia, potentially before ECG changes or angina. This makes it a sensitive tool for diagnosing ischemia, especially in emergency settings.

Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • Echocardiography detects cardiac wall motion abnormalities preceding ECG changes and angina during induced ischemia.
  • Cardiac wall motion abnormalities are a sensitive indicator of myocardial ischemia.
  • Echocardiography is reliable for assessing cardiac function and diagnosing myocardial ischemia.

Purpose of the Study:

  • To evaluate the sensitivity of echocardiography for detecting myocardial ischemia.
  • To assess the utility of echocardiography in emergency department patients with suspected myocardial ischemia.
  • To compare echocardiography with left ventriculography in acute ST-elevation myocardial infarction.

Main Methods:

  • Percutaneous angioplasty to induce ischemic cascade in a cardiac catheterization laboratory.
  • Echocardiography to assess cardiac wall motion abnormalities.
  • Comparison with electrocardiography, angina, and invasive left ventriculography.

Main Results:

  • Echocardiographic wall motion abnormalities precede ECG abnormalities and angina.
  • Echocardiography is comparable to left ventriculography in detecting wall motion abnormalities in acute ST-elevation MI.
  • The utility of echocardiography in low-risk chest pain patients with nondiagnostic presentations is less established.

Conclusions:

  • Echocardiography is a sensitive method for identifying myocardial ischemia.
  • Echocardiography aids in diagnosis and risk assessment for myocardial ischemia in the ED.
  • Further research is needed on echocardiography's role in low-risk chest pain populations.

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