How reliable are echocardiographic studies in the diagnosis of myocardial dysfunction?

Echocardiography is a valuable addition to the assessment of patients with coronary artery disease. Global left ventricular performance can be accurately estimated in most patients by two-dimensional echo, and in others global performance can be inferred from an M-mode echo evaluation of valvular motion. Regional left ventricular performance can be accurately quantitated in specific areas of the left ventricle by measuring myocardial thickness changes on M-mode echocardiography. Almost all areas of the left ventricle can be analyzed by observing wall motion on two-dimensional echo. The latter is an excellent method for detecting aneurysms and left ventricular mural thrombi. Currently, the major limitation of echocardiography for assessing myocardial dysfunction is the inability to obtain diagnostic-quality images in all patients. It is hoped that further technologic advances will eliminate this problem. Should this happen, echocardiography could become the noninvasive technique of choice, since it does not involve exposure to potentially harmful radiation.