[Uni- and cross-sectional bidimensional echocardiography in coronary care unit. Study on 117 patients (author's...

The Authors present the results of an unidimensional and cross-sectional bidimensional echocardiographic study carried out on 117 patients taken into the Coronary Care Unit of the Divisione Rizzi in the Milano-Niguarda Hospital. The purpose of this work was to reconsider the usefulness of this diagnostic methodology in situations of cardiologic emergency, with particular reference to acute coronaropaties. The echocardiographic examination was recorded within 24-48 hours since the admission in CCU of patients taken in for acute myocardial infarction, cardiogenic shock, serious dysrhythmias and unstable angina. In particular, 17 cases of acute myocardial infarction have been followed with cross-sectional bidimensional echocardiography, holding the exams at the time of admission and in II, III, V and XV day of illness. Moreover, such examinations were held in emergency situations as occurred in CCU. All the patients were also investigated from the clinical, electrocardiograhic, radiological and laboratorial point of view. The obtained results were the following: 1) In contrast with unidimensional echocardiography, cross-sectional bidimensional echocardiography has turned out to be technically feasible in all cases; moreover, it has permitted a view of the zones of the left ventricul that couldn't be explored by unidimensional technique. 2) A good correlation has been demonstrated between electrocardiographical location of acute myocardial infarction and dyskinetic zones as seen on the echocadiogram; indeed, in some cases, echocardiography has been able to point out an impairment of wall motion greater than expected only on the basis of electrocardiographic evaluation. 3) Systematic use of the echocardiography in CCU has often been able to point out pathological findings whose diagnosis was not feasible only on the basis of the usual clinical or instrumental data. In conclusion, the Authors confirm the diagnostic and prognostic usefulness of unidimensional echocardiographic study in CCU and underline that the event of cross-sectional bidimensional echocadiography opens new opportunities for the employment of the ultrasonographic methodology, although it is not yet in the position to completely substitute unidimensional echocardiography.