[Echography in the surveillance of myocardial infarction during the acute phase]

An attempt is made to determine feasibility and capabilities of two-dimensional echocardiography (2DE) during acute myocardial infarction (AMI). Seventy-four consecutive patients with AMI (22 anterior, 29 inferior, 4 lateral, 5 non-transmural) underwent 2DE; in sixty cases, suitable examination was available. Regional wall motion abnormalities were studied by 2 methods, i.e. qualitative in all patients and quantitative in 32 patients. Akinesis or dyskinesis occurred in 57 cases (21/22 in anterior, 4/4 in lateral, 29/29 in inferior, 3/5 in non-transmural AMI) and was observed very early (within the first 24 hours after onset of chest pain). Intraventricular clots were observed in 8 patients (in 7 patients during anterior or lateral AMI) without peripheral embolization. In conclusion, 2DE is a suitable method for evaluation of AMI, especially in early thrombi detection and qualitative wall motion analysis. Evolution of quantitative wall excursion is still under investigation but will be highly attractive, more easily repeatable at the bedside and cheaper than nuclear angiography.