Advertisement

Echocardiography in Coronary Artery Disease and Acute Myocardial Infarction

  • Azin Alizadehasl
  • Anita Sadeghpour
Chapter

Abstract

Coronary artery disease is one of the major causes of morbidity and mortality. Imaging modalities represent the key method not only for the evaluation of the disease extent and severity but also for the assessment of hemodynamic complications. In skilled hands, echocardiography provides valuable and beneficial information for clinical management and prognosis study. Complex assessment confers information about global and regional myocardial function, myocardial ischemia, myocardial viability, and ischemic mitral regurgitation as well as about development of complications such as left ventricular clot formation, myocardial rupture, and pericardial effusion. The main disadvantage of echocardiography, however, is the limited echogenicity of many cases and its indubitable operator-dependence. Even so, the ability to bring echocardiographic imaging to the bedside of our cases makes the method crucial and its knowledge essential for all cardiologists.

Keywords

Coronary artery disease echocardiography Acute myocardial infarction Free-wall rupture Pseudoaneurysms Mitral regurgitation Ventricular septal defect 

Abbreviations

CAD

Coronary artery disease

LV

Left ventricle

LV/LA

Left ventricular/Left atrial

LVOT

Left ventricular outflow tract

MI

Myocardial infarction

MR

Mitral regurgitation

MV

Mitral valve

PM

Papillary muscle

RV

Right ventricular

SAM

Systolic anterior motion

STEMI

ST-Segment myocardial infarction

TEE

Transesophageal echocardiography

TTE

Transthoracic echocardiography

VSD

Ventricular septal defect

WMSI

Wall motion score index

Supplementary material

Movie 25.1

Transthoracic Echocardiography, apical four-Chamber view, lateral wall pseduaneurysm with small neck after anterolateral MI (AVI 10092 kb)

Movie 25.2

Transesophageal Echocardiography, mid-esophageal view, Post MI posteromedial papillary muscle rupture resulting flail anterior mitral leaflet and severe acute posterior directed MR (AVI 6067 kb)

Movie 25.3

Transesophageal Echocardiography, mid-esophageal view, Post MI posteromedial papillary muscle rupture resulting flail anterior mitral leaflet and severe acute posterior directed MR (AVI 4555 kb)

Movie 25.4

Transesophageal Echocardiography, mid-esophageal view, Post MI posteromedial papillary muscle rupture resulting flail anterior mitral leaflet and severe acute posterior directed MR (AVI 4891 kb)

Movie 25.5

Transesophageal Echocardiography, mid-esophageal view, Post MI posteromedial papillary muscle rupture resulting flail anterior mitral leaflet and severe acute posterior directed MR (AVI 3117 kb)

Movie 25.6

Transthoracic Echocardiography, apical five-Chamber view, Post MI VSD (AVI 16341 kb)

Movie 25.7

Transthoracic Echocardiography, apical five-Chamber view, Post MI VSD (AVI 17557 kb)

Movie 25.8

Transthoracic Echocardiography, apical four-Chamber view, Fresh, Immobile LV apical fresh clot with concomitant showing in apical short axis view (AVI 11444 kb)

Movie 25.9

Transthoracic Echocardiography, apical four-Chamber view, Fresh, Immobile LV apical fresh clot with concomitant showing in apical short axis view (AVI 12860 kb)

References

  1. 1.
    Flachskampf FA, Schmid M, Rost C, Achenbach S, DeMaria AN, Daniel WG. Cardiac imaging after myocardial infarction. Eur Heart J. 2011;32(3):272.CrossRefGoogle Scholar
  2. 2.
    Votavová R, Linhartová A, Kořínek J, Marek J, Linhart A. Echocardiography in coronary artery disease. Imaging Coron Artery Dis. 2015;57(6):e408–18.Google Scholar
  3. 3.
    Greaves SC. Role of echocardiography in acute coronary syndromes. Heart. 2002;88:419–25.CrossRefGoogle Scholar
  4. 4.
    Giusca S, Jurcut R, Ticulescu R, Dumitru D, Vladaia A, Savu O, Voican A, Popescu BA, Ginghina C. Accuracy of handheld echocardiography for bedside diagnostic evaluation in a tertiary cardiology center: comparison with standard echocardiography. Echocardiography. 2011;28:136–41.CrossRefGoogle Scholar
  5. 5.
    Dencker M, Tasevska G, Grubb D, Stagmo M, Gustafsson R. Unexpected rupture of the left ventricular free wall in the echo-lab. Eur J Echocardiogr. 2008;9:92–4.PubMedGoogle Scholar
  6. 6.
    Morimoto H, Mukai S, Obata S, Fujiwara Y. Left ventricular free wall rupture after coronary artery bypass grafting. Eur J Cardiothorac Surg. 2012;41:707.CrossRefGoogle Scholar
  7. 7.
    Kwan J, Shiota T, Agler DA, Popović ZB, Qin JX, Gillinov MA, Stewart WJ, Cosgrove DM, McCarthy PM, Thomas JD, study R-t t-d e. Geometric differences of the mitral apparatus between ischemic and dilated cardiomyopathy with significant mitral regurgitation: real-time three-dimensional echocardiography study. Circulation. 2003;107:1135–40.CrossRefGoogle Scholar
  8. 8.
    Grigioni F, Detaint D, Avierinos JF, Scott C, Tajik J, Enriquez-Sarano M. Contribution of ischemic mitral regurgitation to congestive heart failure after myocardial infarction. J Am Coll Cardiol. 2005;45:260–7.CrossRefGoogle Scholar
  9. 9.
    Donoiu I, Istratoaie O, Ionescu DD. Ventricular septal rupture after acute myocardial infarction. Hell J Cardiol. 2010;51:374–6.Google Scholar
  10. 10.
    Goldberger JJ, Himelman RB, Wolfe CL, Schiller NB. Right ventricular infarction: recognition and assessment of its hemodynamic significance by two-dimensional echocardiography. J Am Soc Echocardiogr. 1991;4:140–6.CrossRefGoogle Scholar
  11. 11.
    Figueras J, Barrabés JA, Serra V, Cortadellas J, Lidón RM, Carrizo A, Garcia-Dorado D. Hospital outcome of moderate to severe pericardial effusion complicating ST-elevation acute myocardial infarction. Circulation. 2010;122:1902–9.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Azin Alizadehasl
    • 1
  • Anita Sadeghpour
    • 2
  1. 1.Associate Professor of Cardiology, Echocardiologist, Echocardiography and Cardiogenetic Research CentersCardio-Oncology Department, Rajaie Cardiovascular Medical and Research CenterTehranIran
  2. 2.Professor of CardiologyEchocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical ScienceTehranIran

Personalised recommendations