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Apex two dimensional echocardiography. Alternative approach to quantification of acute myocardial infarction
Insights
Apex echocardiography effectively detects and quantifies acute myocardial infarction when standard views are blocked. This method shows left ventricular dysfunction and correlates well with cardiac enzyme levels for reliable early diagnosis.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Standard echocardiography views are often obscured in acute myocardial infarction cases.
- Early and accurate diagnosis of myocardial infarction is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of apex echocardiography in detecting and quantifying acute myocardial infarction.
- To assess the correlation between echocardiographic findings and biochemical markers of myocardial damage.
Main Methods:
- Fifty-three patients within 12 hours of first myocardial infarction symptoms were studied.
- Three apical long axis views were acquired, and echocardiograms were analyzed for segmental asynergy.
- Correlation with electrocardiogram (ECG) and creatine kinase MB (CK MB) levels was assessed.
Main Results:
- Satisfactory echocardiograms were obtained in 91% of patients.
- Left ventricular asynergy was detected in all 48 evaluable patients.
- A positive correlation was found between echocardiographic infarct localization and ECG findings in 46 patients.
- Estimated asynergic area correlated well with peak CK MB levels.
Conclusions:
- Apex echocardiography is a reliable alternative for detecting and quantifying acute myocardial infarction.
- This technique is effective even when standard parasternal acoustic windows are occluded.
- It provides valuable information for early diagnosis and assessment of infarct severity.
Abstract:
Apex echocardiography has been chosen as an approach to detect and quantify acute myocardial infarction because the usual parasternal acoustic windows are often occluded. Fifty-three patients were studied, all within 12 hours after the onset of symptoms of their first myocardial infarction. Three apical long axis views were obtained, that is the two and four chamber views, and the right anterior oblique equivalent or three chamber view. Satisfactory echocardiograms were obtained in 48 patients (91%). The individual apical views were divided into equal segments and the area of asynergy was estimated in each view. Left ventricular asynergy was present in all 48 patients. In 46 patients a positive correlation between the electrocardiogram and the echocardiogram was obtained, as far as infarct localisation was concerned. The estimated asynergic area correlated well with the peak value of the isoenzyme of creatine kinase (CK MB). Apex echocardiography is a reliable alternative method of detecting and quantifying myocardial infarction soon after the onset of symptoms.