Early echocardiographic detection of acute myocardial infarction

Early echocardiographic wall motion changes were detected in a patient with subepicardial infarction of the true posterior wall. Left ventricular wall excursion and velocities were found diminished one hour following the onset of symptoms and before any significant electrocardiographic changes. Sublingual nitroglycerin administration reverted the hypokinetic posterior wall to normal but only temporarily. These observations may be of added value in the early detection of the acute myocardial ischaemia.