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Is follow-up echocardiogram mandatory after a STEMI?

Sathish Kumar Parasuraman1, Janaki Srinivasan2, Paul Broadhurst3

  • 1Musgrove Park Hospital, Taunton, UK.

Echo Research and Practice
|December 6, 2022
PubMed

Insights

Routine echocardiograms after ST-segment elevation myocardial infarction (STEMI) are not standard unless ejection fraction is low. This case highlights a left ventricular pseudoaneurysm found 6 months post-STEMI, suggesting broader follow-up may be warranted.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Clinical Case Study

Background:

  • Current guidelines recommend follow-up echocardiograms post-ST-segment elevation myocardial infarction (STEMI) only if left ventricular ejection fraction is ≤40%.
  • This approach may overlook serious complications in patients with preserved ejection fraction.

Purpose of the Study:

  • To present a case of left ventricular pseudoaneurysm diagnosed 6 months after STEMI.
  • To question the current guideline's restrictive approach to post-STEMI echocardiogram follow-up.

Main Methods:

  • A case report detailing a patient's diagnosis and treatment.
  • Diagnostic imaging, specifically echocardiography, was utilized.

Main Results:

  • A left ventricular pseudoaneurysm was identified 6 months after the initial STEMI event.
  • The patient was successfully treated using a percutaneous closure device.

Conclusions:

  • This case suggests that routine echocardiogram follow-up after STEMI, even in patients with minimal symptoms and preserved ejection fraction, should be reconsidered.
  • Early detection of complications like pseudoaneurysms can lead to successful interventions.

Keywords:
2D echocardiographyLV aneurysmaneurysmleft ventricular pseudo-aneurysmpost STEMI echo

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