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[Evaluation of myocardial infarction by ECG gated cardiac computed tomography (author's transl)]
Insights
Cardiac computed tomography (CT) is a useful noninvasive tool for evaluating old myocardial infarction. It effectively detects abnormal wall motion, thin walls, mural thrombi, and left ventricular aneurysms.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Context:
- Old myocardial infarction can lead to various complications affecting left ventricular function and structure.
- Accurate assessment of these complications is crucial for patient management and prognosis.
Purpose:
- To evaluate the utility of ECG-gated cardiac computed tomography (CT) in detecting abnormalities in patients with old myocardial infarction.
- To compare cardiac CT findings with left ventriculography and coronary arteriography.
Summary:
- ECG-gated cardiac CT was performed in 9 patients with old myocardial infarction.
- Cardiac CT identified thin, abnormally moving infarcted myocardium, mural thrombi, and left ventricular aneurysms.
- Findings were correlated with left ventriculography, showing good agreement for thrombi and aneurysms.
Impact:
- Cardiac CT is a valuable noninvasive method for diagnosing complications of old myocardial infarction.
- It aids in detecting abnormal wall motion, thinned walls, mural thrombi, and left ventricular aneurysms.
- This can improve diagnostic accuracy and inform treatment strategies.
Abstract:
ECG gated cardiac computed tomography (cardiac (T) was performed in 9 cases with old myocardial infarction. Seven of these had anterio-septal infarction, one had inferior wall infarction and the remaining one had posterior wall infarction. All were investigated by left ventriculography and coronary arteriography. Cardiac CT was performed after intravenous administration of contrast medium usually given as a bolus injection. The infarcted myocardium was thin and showed abnormal wall motion in cardiac CT, but the motion did not always coincide with left ventricular cineangiographic findings. In 3 cases, mural thrombi at the left ventricular apex were observed by cardiac CT, and in 2 of which the thrombi were confirmed by left ventriculography. In 2 cases, cardiac CT showed stasis of contrast medium and aneurysmal formation in the left ventricular cavity and the aneurysms were confirmed by left ventriculography. Sequential 8 mm thick non-ECG gated cardiac CT scans from the cardiac apex to the base were performed in 7 cases with anterio-septal infarction, and the infarcted area were observed in the anterior interventricular septum in 6 cases. We concluded that cardiac CT was a useful noninvasive method to detect abnormal wall motion, abnormally thin wall, mural thrombus and left ventricular aneurysm in old myocardial infarction.