Immediate detection of early high-risk patients with acute myocardial infarction using two-dimensional echocardiographic evaluation of left ventricular regional wall motion abnormalities

Horowitz, Richard; Morganroth, Joel

doi:10.1016/0002-8703(82)90393-3

Cited by 120 publications

(13 citation statements)

References 35 publications

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“…Horowits et al 12 concluded that high RWMI was associated with higher complications. In the present study, the mean RWMI in patients with complicated AMI was 1.84 (SD 0.27) while in others it was 1.49 (SD 0.26) which is statistically significant.…”

Section: Myocardial Wall Motion Abnormalitymentioning

confidence: 99%

Role of Early 2D Echocardiography in Patient with Acute Myocardial Infarction in Correlation with Electrocardiography and Clinical Presentation

Kodilkar¹,

Patil²,

Chafekar³

et al. 2014

mvpjms

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Introduction: Echocardiography is noninvasive, most frequently used usually the initial imaging test to evaluate all cardiovascular disease related to structural, functional, or hemodynamic abnormality of the heart or great vessels. The major advantage of echocardiography is the ability to obtain instantaneous real time image even in emergency units. The present study was undertaken to evaluate left ventricular function, extent of myocardium involved and complications of acute myocardial infarction by 2D ECHO, to correlate these findings with ECG and clinical presentation, and to assess the role of 2D ECHO in management and prognosis of patients with acute myocardial infarction. Materials and Methods: The present study was conducted on patients visiting our tertiary health centre, Nasik over a period of 2 years. 55 patients were included in the study. Patients with prior history of acute myocardial infarction, valvular heart disease, cardiomyopathy, cardiac surgery, congenital heart disease and non ST elevation MI were not included in the study. Patients were classified as per Killip classification and 2D ECHO was performed on the patients within 24 hours of admission. The findings of which were correlated with clinical and ECG findings. Results: Of 55 patients studied it was found that MI had male preponderance with hypertension as major risk factor. Also, the severity of the infarction increased with the increase in the Killip class. Mean ejection fraction was also observed to be decreasing in patients with increase in severity of the infarction. Conclusion: 2D ECHO performed within 24 hours of admission helps the clinician to predict and diagnose complications in patients with acute MI and take proper steps in the management of the patient.

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Section: Myocardial Wall Motion Abnormalitymentioning

confidence: 99%

Role of Early 2D Echocardiography in Patient with Acute Myocardial Infarction in Correlation with Electrocardiography and Clinical Presentation

Kodilkar¹,

Patil²,

Chafekar³

et al. 2014

mvpjms

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“…Similar results have been published for patients undergoing CABG surgery.17,40 Other data suggest an additional role for TEE in determining the prognostic significance of myocardial ischemia in patients with acute MI and those with CABG. 17,42 However, work by Eisenberg et a141 involving 332 men at high risk for CAD undergoing noncardiac surgery did not find TEE to be superior to ECG.…”

Section: Teementioning

confidence: 99%

Monitoring Perioperative Ischemia

Williams

2001

Semin Cardiothorac Vasc Anesth

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surgery and whether perioperative ischemia leads to increased morbidity and mortality in patients with coronary artery disease (CAD) who are undergoing surgery. Based on previous studies, it is generally accepted that perioperative ischemia is common in patients with CAD undergoing noncardiac surgery. The incidence of ischemia during the operative period varies greatly with cardiac risk factors, type of surgery, duration of surgery, and the monitor used to detect ischemia. Because perioperative cardiac morbidity is the leading cause of death after anesthesia and surgery, it is prudent for the anesthesia clinician to have an understanding of the tools available for monitoring as well as their clinical utility. These tools are summarized, and recommendations are made regarding their use. Copyright © 2001 by W.B. Saunders Company. W y should we monitor for ischemia during Y Y surgery? Does perioperative ischemia lead to increased morbidity and mortality in patients with coronary artery disease (CAD) undergoing surgery? Slogoff and Keatsl addressed these questions in a prospective study involving 1,023 patients undergoing elective coronary artery bypass grafting (CABG). They found electrocardiographic (ECG) evidence of ischemia in 36.9% of their patients. Postoperative myocardial infarction (PMI) was 3 times more prevalent in patients with ischemia (6.9% v 2.5%). These results were confirmed in another 495 patients undergoing CABG; PMI occurred in 6.3% of the patients with ECG evidence of ischemia, compared with 1.8% of patients without ECG evidence of ischemia.2 An increase in PMI has also been demonstrated in patients with CAD undergoing noncardiac surgery. Mangano et a13 showed the incidence of preoperative, intraoperative, and postoperative ischemia to be 20%, 25%, and 41%, respectively, in men with cardiac risk factors who were undergoing major surgery. PMI conferred a 9-fold increase in the odds of having an ischemic event, defined as cardiac death, nonfatal myocardial infarction (MI), or unstable angina. Thus, it is generally accepted that perioperative ischemia is common in patients with CAD undergoing noncardiac surgery.The incidence of ischemia varies during the operative period, with preoperative rates ranging from 9.5% to 42%, 3-5 intraoperative rates of 18% to 74%,3-9 and postoperative rates of 2'7% to 41 %.3-5 These rates vary greatly with cardiac risk factors, type of surgery, duration of surgery, and the monitor used to detect ischemia. Because perioperative cardiac morbidity is the leading cause of death after anesthesia and surgery, it is prudent for the anesthesia clinician to have an understanding of the tools available for monitoring as well as their clinical utility. These tools are summarized, and recommendations are made regarding their use. Surface ElectrocardiographyStandard surface ECG is the most common perioperative technique used to monitor for myocardial ischemia. When ECG is used, more than 80% of ischemia episodes present as ST segment depressions. ST elevations are much less com-

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“…Two-dimensional echocardiography can be used to identify patients with acute MI who are at high risk for shortterm complications in the hospital and for long-term complications after hospital discharge [ 163 -166 ]. Horowitz and Morganroth [ 164 ] found that echocardiography had a sensitivity of 83 % and a specifi city of 85 % in identifying patients at high risk for in-hospital complications. The 2011 ACC/ AHA/ASE appropriate-use task force classifi ed as appropriate the use of echocardiography for the initial evaluation of ventricular function and for follow-up reevaluation when the results are used to guide therapy [ 39 ].…”

Section: Prognosis In Acute Myocardial Infarction and Chronic Coronarmentioning

confidence: 99%

Echocardiographic Evaluation of Coronary Artery Disease

Coulter¹

2015

Coronary Artery Disease

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Echocardiographic evaluation of patients with coronary artery disease (CAD) is a low cost, portable, and non-invasive imaging tool that is available in almost all hospitals and in many offi ce settings. Detection of a discreet impairment in regional left ventricular mechanical function by echocardiography provides real time cardiac imaging useful in the evaluation and diagnosis of acute and chronic CAD. Echocardiography helps to establish the diagnosis, location, and extent of ischemia and it identifi es mechanical complications of infarction and provides prognostic information for risk stratifi cation. Stress echocardiography, by induction of regional wall motion abnormalities with treadmill or bicycle exercise or following dobutamine pharmacologic stress, is routinely used to demonstrate the presence of CAD, to risk stratify patients, and to assess myocardial viability prior to revascularization. Newer echocardiographic parameters, such as strain rate and perfusion, have improved the accuracy in CAD detection and are complementary adjuncts in stress echocardiography.

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Immediate detection of early high-risk patients with acute myocardial infarction using two-dimensional echocardiographic evaluation of left ventricular regional wall motion abnormalities

Cited by 120 publications

References 35 publications

Role of Early 2D Echocardiography in Patient with Acute Myocardial Infarction in Correlation with Electrocardiography and Clinical Presentation

Role of Early 2D Echocardiography in Patient with Acute Myocardial Infarction in Correlation with Electrocardiography and Clinical Presentation

Monitoring Perioperative Ischemia

Echocardiographic Evaluation of Coronary Artery Disease

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