Echocardiographic assessment of left ventricular function in patients of acute myocardial infarction

Abstract

INTRODUCTIONAcute myocardial infarction is one of the leading causes of death in developing countries like India. The mortality rate with AMI is approximately 30%. Although mortality rate after hospital admission for AMI has declined by about 30% over the last two decades, approximately 1 of every 25 patients who survive the initial hospitalization die in first year after AMI.1 Survival after AMI is markedly reduced in elderly patients (age over 75 years) cardiogenic shock, LV failure and Arrythmias are the leading cause of death early post AMI period. While LV dysfunction and thromboembolism contribute to late mortality and morbidity.After AMI, LV undergoes a series of changes in shape, size and thickness in both the infarcted and non-infarcted segments. This process is called ventricular remodeling.This leads to progressive dilatation of ventricles with ventricular dysfunction. This dysfunction gives rise to late complications after AMI. ABSTRACTBackground: 2D Echo can evaluate LV anatomy, function and diagnose post AMI complications in early stages, thus help in management and determining the prognosis. The present study was undertaken to evaluate LV function in patient following AMI and also to find out the incidence of various echocardiographically detectable complications of following AMI. Methods: The present study was conducted on patients visiting our tertiary health centre during study duration. 50 patients were included in the study. Patients with prior history of acute myocardial infarction, pericarditis and early repolarisation syndrome, and primary myocardial disease diagnosed by serum enzyme levels were not included in the study. Patients were classified as per Killip classification and 2D echo study was performed in all patients. Results: Maximum incidence of AMI was found in 51-60 years of age, with male predominance (64%). Anterior wall AMI (58%) was more common. 94% of patients had wall motion abnormalities. Incidence of LV thrombus was found to be 24%. In present study, as the extent and severity of wall motion abnormalities increased, the incidence of LV thrombus also increased. Thus, 2DE study of LV regional wall motion can predict the incidence of LV thrombus. Conclusions: The echocardiographic assessment of LV function in patients of AMI is important as, it detects the regional wall motion abnormality, LVEF and also the complications like LV thrombus, pericardial effusion and LV aneurysm. These observations are of great value in the management of AMI.

Role of Cardiac Magnetic Resonance (CMR) Imaging inthe Assessment of Wall Motion Abnormalities in MyocardialInfarction Patients

“…(27.8%) of patients in group (C) showed hypokinesia, (5%) Akinesia, and (8%) dyskinesia, majority were associated with RCA lesions in form of critical and total occlusions. In contrast to our results, Shivpuje Anjali and Page [ 9] reported that transmural MI is associated with akinesia or dyskinesiaand that hypokinesis is nonspecific and is less significant in distinguishing between injured and uninjured myocardium. These may be due to the use of 2D echocardiography in the assessment which us less accurate than CMR.…”

Short Term Complications of Acute Myocardial Infarction in a Tertiary Hospital

“…Echocardiographic assessment of cardiac function shows Systolic dysfunction (33 %) both systolic and diastolic dysfunction (30%) diastolic dysfunction (15%). These findings are similar to findings in other studies [16][17] . Acute Left ventricular failure was the most common complications (23%), followed by arrythmia (17%) and cardiogenic shock (13%).…”

Outcome of Thrombolytic Therapy in Hypertensives with Acute Myocardial Infarction

“…2 Although the mortality rate after admission for AMI has declined by 30% over the past two decades, approximately 1 of every 25 patients who survive the initial hospitalization dies in the first year after AMI. 3 Chronic systemic hypertension (HTN) is one of the established cardiovascular risk factors for the development of atherosclerosis and an increased incidence of peripheral vascular disease, cerebrovascular disease, chronic renal disease. 4 Hypertension causes an increase in left ventricular mass and fibrous tissue resulting in increased stiffness of the left ventricle leading possibly to reduced coronary reserve, silent myocardial ischemia, and abnormal electrophysiological properties of hypertrophied myocytes and conduction disturbances.…”