Emergent use of echocardiography in a post-myocardial infarction patient with acute dyspnea

Acute dyspnea in a post-myocardial infarction patient may prompt the physician to use further diagnostic testing to evaluate apparent worsening left ventricular function, ischemia, mitral valve dysfunction, chordae or valvular rupture, or a ventricular septal defect producing a left to right shunt. We present a case of a 62-year-old woman with an unrecognized myocardial infarction at home who presented to the emergency department (ED) acutely dyspneic and free of chest pain. Prompt evaluation in the ED with echocardiography and Doppler imaging proved time-efficient and allowed early lifesaving surgery to be performed. We propose that access to emergent echocardiography in select cases should be a standard service in every ED.