The role of cardiac ultrasound in the diagnosis of the ‘surgical’ complications of acute myocardial infarction

  • John H. Smyllie
  • Patricia E. Assmann
  • George R. Sutherland
  • Alan G. Fraser
  • Jos R. T. C. Roelandt
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 113)

Abstract

Two-dimensional echocardiography is a useful technique for the diagnosis of patients presenting with myocardial infarction. It can rapidly differentiate acute myocardial infarction from other causes of acute severe chest pain such as thoracic aortic dissection, pericarditis and aortic valve disease. The technique has also become a major diagnostic tool for the detection of the mechanical complications of myocardial infarction which in many cases can be corrected by surgical intervention. In addition Doppler echocardiography and more particularly color Doppler flow mapping help to assess the hemodynamic and blood flow abnormalities resulting from these complications so that their presence and severity can be readily evaluated at the bedside in the coronary care unit. The diagnostic potential of both methods may be extended by the transesophageal approach offering an alternative window to the heart when the precordial windows provide poor quality images. This is especially true in immobile, supine patients on ventilators or with an intra aortic counterpulsation in situ. However, at the present time, the reported experience with transesophageal echocardiography in the assessment of the acute complications of myocardial infarction is limited.

Keywords

Acute Myocardial Infarction Mitral Regurgitation Ventricular Septal Defect Cardiac Rupture Left Ventricular Thrombus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Zeman FD, Rodstein M (1960) Cardiac rupture complicating myocardial infarction in the aged. Arch Int Med 105: 121–132.Google Scholar
  2. 2.
    Lewis AJ, Burchell HB, Titus JL (1969) Clinical and pathologic features of postinfarction cardiac rupture. Am J Cardiol 23: 43–53.PubMedCrossRefGoogle Scholar
  3. 3.
    Naeim F, De la Moza LM, Robbins SL (1972) Cardiac rupture during myocardial infarction: A review of 44 cases. Circulation 45: 1231–1239.PubMedGoogle Scholar
  4. 4.
    Bates RJ, Beutler S, Reskenov L, Anagnastopoulos CE (1977) Cardiac rupture-challenge in diagnosis and management. Am J Cardiol 40: 429–437.PubMedCrossRefGoogle Scholar
  5. 5.
    Windsor HM, Chang VP, Shanahan MX (1982) Postinfarction cardiac rupture. J Thorac Cardiovasc Surg 84: 755–761.PubMedGoogle Scholar
  6. 6.
    Desoutter P, Halphen C, Haiat R (1984) Two-dimensional echocardiographic visualization of free ventricular wall rupture in acute myocardial infarction. Am Heart J 108: 1360–1361.PubMedCrossRefGoogle Scholar
  7. 7.
    Hochreiter C, Goldstein J, Borer JS, Tyberg T, Goldberg HL, Subramanian V, Rosenfeld I (1982) Myocardial free-wall rupture after acute infarction: Survival aided by percutaneous intra-aortic balloon counterpulsation. Circulation 65: 1279–1282.PubMedCrossRefGoogle Scholar
  8. 8.
    Balakumaran K, Verbaan CJ, Essed CE, Nauta J, Bos E, Haalebos MMP, Penn O, Simoons ML, Hugenholtz PG (1984) Ventricular free wall rupture: Sudden, subacute, slow, sealed and stabilized varieties. Eur Heart J 5: 282–288.PubMedGoogle Scholar
  9. 9.
    Hagemeijer F, Verbaan CJ, Sonke PCF, de Rooy CH (1980) Echocardiography and rupture of the heart. Br Heart J 43: 45–46.PubMedCrossRefGoogle Scholar
  10. 10.
    Qureshi SA, Rissen T, Gray KE (1982) Survival after subacute cardiac rupture. Br Heart J 47: 180–182.PubMedCrossRefGoogle Scholar
  11. 11.
    Matangi MF, Norris RM, Hill DG (1983) Subacute cardiac rupture: A surgical emergency. NZ Med J 96: 1003–1005.Google Scholar
  12. 12.
    Hermoni Y, Engel PJ (1986) Two-dimensional echocardiography in cardiac rupture. Am J Cardiol 57: 180–181.PubMedCrossRefGoogle Scholar
  13. 13.
    Schiller NB, Botvinick (1977) Right ventricular compression as a sign of cardiac tamponade. Circulation 56: 774–779.PubMedGoogle Scholar
  14. 14.
    Armstrong WF, Schilt BF, Helper DJ, Dillon JC, Feigenbaum H (1982) Diastolic collapse of the right ventricle with cardiac tamponade: An echocardiographic study. Circulation 65: 1491–1496.PubMedCrossRefGoogle Scholar
  15. 15.
    Gillam LD, Guyer DE, Gibson TC, King ME, Marshall JE, Weyman AE (1983) Hydro- dynamic compression of the right atrium: A new echocardiographic sign of cardiac tamponade. Circulation 68: 294–301.PubMedCrossRefGoogle Scholar
  16. 16.
    Kronzon I, Cohen ML, Winer HE (1983) Diastolic atrial compression: A sensitive echocardiographic sign of cardiac tamponade J Am Coll Cardiol 2: 770–775.PubMedCrossRefGoogle Scholar
  17. 17.
    Fast J, Wielenga RP, Janssen E, Schuurmans Stekhoven JH (1986) Abnormal wall movements of the right ventricle and both atria in patients with pericardial effusion as indicators of cardiac tamponade. Eur Heart J 7: 431–436.PubMedGoogle Scholar
  18. 18.
    Vlodaver Z, Coe JI, Edwards JE (1975) True and false aneurysms: Propensity of the latter to rupture. Circulation 51: 567–72.PubMedGoogle Scholar
  19. 19.
    Roelandt J, Brand M vd, Vletter WB, Nauta J, Hugenholtz PG (1975) Echocardiographic diagnosis of pseudoaneurysm of the left ventricle. Circulation 52: 466–472.PubMedGoogle Scholar
  20. 20.
    Morcerf FP, Duarte EP, Salcedo EE, Siegel W (1976) Echocardiographic findings in false aneurysm of the left ventricle. Cleve Clin Q 43: 71–76.PubMedGoogle Scholar
  21. 21.
    Sears TD, Ong YS, Starke H, Forker AD (1979) Left ventricular pseudoaneurysm identified by cross-sectional echocardiography. Ann Int Med 90: 935–936.PubMedGoogle Scholar
  22. 22.
    Katz RJ, Simpson A, DiBianco R, Fletcher RD, Bates HR, Sauerbrunn BJL (1979) Noninvasive diagnosis of left ventricular pseudoaneurysm. Am J Cardiol 44: 372–377.PubMedCrossRefGoogle Scholar
  23. 23.
    Catherwood E, Mintz GS, Kother MN, Parry WR, Segal BL (1980) Two-dimensional echocardiographic recognition of left ventricular pseudoaneurysm. Circulation 60: 294–303.Google Scholar
  24. 24.
    Gatewood RP, Nanda NC (1980) Differentiation of left ventricular pseudoaneurysm from true aneurysm with two dimensional echocardiography. Am J Cardiol 46: 869–878.PubMedCrossRefGoogle Scholar
  25. 25.
    Zijlstra F, Roelandt J (1985) The left ventricular false aneurysm. Ned Tijdschr Geneesk 129: 1473–1478.Google Scholar
  26. 26.
    Brabandt H v, Piessens J, Stalpeart J, de Geest H (1985) Pseudoaneurysm of the left ventricle following cardiac surgery. Report of 3 cases and review of the literature. Thor Cardio- vasc Surg 33: 118–124.CrossRefGoogle Scholar
  27. 27.
    Roelandt JRTC, Sutherland GR, Yoshida K, Yoshikawa J (1988) Improved diagnosis and characterisation of left ventricular pseudoaneurysm by Doppler colour flow imaging. J Am Coll Cardiol 85: 807–811.CrossRefGoogle Scholar
  28. 28.
    Sutherland GR, Smyllie JH, Roelandt JTC (1989) Advantages of colour flow imaging in the diagnosis of left ventricular pseudoaneurysm. Br Heart J 61: 59–64.PubMedCrossRefGoogle Scholar
  29. 29.
    Moore CA, Nygaard TW, Kaiser DL, Cooper AA, Gibson RS (1986) Postinfarction ventricular septal rupture: The importance of location of infarction and right ventricular function in determining survival. Circulation 74: 45–55.PubMedCrossRefGoogle Scholar
  30. 30.
    Scanlan JG, Seward JB, Tajik AJ (1979) Visualization of ventricular septal rupture utilizing wide-angle two-dimensional echocardiography. Mayo Clin Proc 54: 381–384.PubMedGoogle Scholar
  31. 31.
    Bishop HL, Gibson RS, Stamm RB, Bellen GA, Martin RP (1981) Role of two-dimensional echocardiography in the evaluation of patients with ventricular septal rupture postmyocar- dial infarction. Am Heart J 102: 965–971.PubMedCrossRefGoogle Scholar
  32. 32.
    Mintz GS, Victor MF, Kotler MN, Parry WR, Segal BL (1981) Two-dimensional echocardiography identification of surgically correctable complications of acute myocardial infarction. Circulation 64: 91–96.PubMedCrossRefGoogle Scholar
  33. 33.
    Drobac M, Gilbert B, Howard R, Baigrie R, Rakowski H (1983) Ventricular septal defect after myocardial infarction: Diagnosis by two-dimensional contrast echocardiography. Circulation 67: 335–341.PubMedCrossRefGoogle Scholar
  34. 34.
    Rogers EW, Glassman RD, Feigenbaum H, Weyman AE, Godley RW (1980) Aneurysms of the posterior interventricular septum with postinfarction ventricular septal defect. Chest 78: 741–746.PubMedCrossRefGoogle Scholar
  35. 35.
    Stephens JD, Giles MR, Banim SO (1981) Ruptured postinfarction ventricular septal aneurysm causing chronic congestive cardiac failure. Br Heart J 46: 216–219.PubMedCrossRefGoogle Scholar
  36. 36.
    Hodsden J, Nanda NC (1981) Dissecting aneurysm of the ventricular septum following acute myocardial infarction: Diagnosis by real time two-dimensional echocardiography. Am Heart J 101: 671–672.PubMedCrossRefGoogle Scholar
  37. 37.
    Meltzer RS, Schwartz J, French J, Popp RL (1979) Ventricular septal defect noted by two- dimensional echocardiography. Chest 76: 455–457.PubMedCrossRefGoogle Scholar
  38. 38.
    Farcot JC, Boisante L, Rigaud M, Bardet J, Bourdarius JP (1980) Two-dimensional echocardiographic visualization of ventricular septal rupture after acute anterior myocardial infarction. Am J Cardiol 45: 370–377.PubMedCrossRefGoogle Scholar
  39. 39.
    Recusani F, Raisaro A, Sgalambro A, Tronconi L, Venco A, Salerno J, Ardissino D (1984) Ventricular septal rupture after myocardial infarction: Diagnosis by two-dimensional and pulsed Doppler echocardiography. Am J Cardiol 54: 277–281.PubMedCrossRefGoogle Scholar
  40. 40.
    Keren G, Sherez J, Roth A, Miller H, Laniado S (1984) Diagnosis of ventricular septal rupture from acute myocardial infarction by combined 2-dimensional and pulsed Doppler echocardiography. Am J Cardiol 53: 1202–1203.PubMedCrossRefGoogle Scholar
  41. 41.
    Miyatake K, Okamoto M, Kinoshita N, Park YD, Nagata S, Izumi S, Fusejima K, Sakakibara H, Nimura Y (1985) Doppler echocardiographic features of ventricular septal rupture in myocardial infarction. J Am Coll Cardiol 5: 182–187.PubMedCrossRefGoogle Scholar
  42. 42.
    Smith G, Endresen K, Swersstsen E, Semb G (1985) Ventricular septal rupture diagnosed by simultaneous cross-sectional echocardiography and Doppler ultrasound. Eur Heart J 6: 631–636.PubMedGoogle Scholar
  43. 43.
    Smyllie JH, Dawkins K, Conway N, Sutherland GR (1989) The diagnosis of ventricular septal defect following myocardial infarction: the value of colour flow mapping. Br Heart J 62: 260–7.PubMedCrossRefGoogle Scholar
  44. 44.
    Kaplan MA, Harris CN, Kay JH, Parker DP, Magidson O (1976) Postinfarction ventricular septal rupture. Clinical approach and surgical results. Chest 69: 734–738.PubMedCrossRefGoogle Scholar
  45. 45.
    Koenig K, Kasper W, Hofman T, Meinertz T, Just H (1987) Transesophageal echocardiography for the diagnosis of rupture of the ventricular septum or left ventricular papillary muscle rupture during myocardial infarction. Am J Cardiol 59: 362.PubMedCrossRefGoogle Scholar
  46. 46.
    Wei JY, Hutchins GM, Bulkley BH (1979) Papillary muscle rupture in fatal acute myocardial infarction: A potentially treatable form of cardiogenic shock. Ann Intern Med 90: 149–152.PubMedGoogle Scholar
  47. 47.
    Nishimura RA, Schaff HV, Shub C, Gersh BJ, Edwards WD, Tajik AJ (1983) Papillary muscle rupture complicating acute myocardial infarction: Analysis of 17 patients. Am J Cardiol 51: 373–377.PubMedCrossRefGoogle Scholar
  48. 48.
    Erbel R, Schweizer P, Bardos P, Meyer J (1981) Two-dimensional echocardiographic diagnosis of papillary muscle rupture. Chest 79: 595–598.PubMedCrossRefGoogle Scholar
  49. 49.
    Scully RE, Mark EJ, McNeely BU (1982) Case records of the Massachusetts General Hospital. N Engl J Med 307: 873–880.CrossRefGoogle Scholar
  50. 50.
    Come PC, Riley MF, Weintraub R, Morgan JP, Nakao S (1985) Echocardiographic detection of complete and partial papillary muscle rupture during acute myocardial infarction. Am J Cardiol 56: 787–789.PubMedCrossRefGoogle Scholar
  51. 51.
    Ballester M, Foale R, Presbitero P, Yacoub M, Rickards A, McDonald L (1983) Cross-sectional echocardiographic features of ruptured chordae tendineae. Eur Heart J 4: 795–802.PubMedGoogle Scholar
  52. 52.
    Godley RW, Wann LS, Rogers EW, Feigenbaum H, Weyman AE (1981) Incomplete mitral leaflet closure in patients with papillary muscle dysfunction. Circulation 3: 565–571.CrossRefGoogle Scholar
  53. 53.
    Abbasi AS, Allen MW, DeCristofaro D, Ungar I (1980) Detection and estimation of the degree of mitral regurgitation by rangegated pulsed Doppler echocardiography. Circulation 61: 143–147.PubMedGoogle Scholar
  54. 54.
    Ascah KJ, Stewart WJ, Jiang L, Guerrero JL, Newell JB, Gillam LD, Weyman AE (1985) A Doppler two-dimensional echocardiographic method for quantitation of mitral regurgitation. Circulation 2: 377–383.CrossRefGoogle Scholar
  55. 55.
    Veyrat C, Ameur A, Bas S, Lessana A, Abitbol G, Kalmanson D (1984) Pulsed Doppler echocardiographic indices for assessing mitral regurgitation. Br Heart J 51: 130–138.PubMedCrossRefGoogle Scholar
  56. 56.
    Helmcke F, Nanda NC, Hsiung MC et al. (1987) Color Doppler assessment of mitral regurgitation with orthogonal planes. Circulation 75: 175–183.PubMedCrossRefGoogle Scholar
  57. 57.
    Skoulas A, Beier RL (1967) Dissecting perforation of infarcted interventricular septum with associated posterior papillary muscle involvement. Am J Med 43: 461–464.PubMedCrossRefGoogle Scholar
  58. 58.
    Rawlins MD, Medel D, Braimbridge MV (1972) Ventricular septal defect and mitral regurgitation secondary to myocardial infarction. Br Heart J 34: 322–324.PubMedCrossRefGoogle Scholar
  59. 59.
    Fleming HA (1973) Ventricular septal defect and mitral regurgitation secondary to myocardial infarction. Br Heart J 35: 344–346.PubMedCrossRefGoogle Scholar
  60. 60.
    Gowda KS, Loh CW, Roberts R (1976) The simultaneous occurrence of a ventricular septal defect and mitral insufficiency after myocardial infarction. Am Heart J 92: 234–236.PubMedCrossRefGoogle Scholar
  61. 61.
    Zaidi SA (1977) The simultaneous occurrence of a ventricular septal defect and mitral insufficiency after myocardial infarction. Am Heart J 9A: 538–539.CrossRefGoogle Scholar
  62. 62.
    Radford MJ, Johnson RA, Daggett WM, Fallon JT, Buckley MJ, Gold HK, Leinbach R (1981) Ventricular septal rupture: A review of clinical and physiologic features and an analysis of survival. Circulation 3: 545–553.CrossRefGoogle Scholar
  63. 63.
    Stevenson JG, Kawabori I, Guntheroth WG (1977) Differentiation of ventricular septal defects from mitral regurgitation by pulsed Doppler echocardiography. Circulation 56: 14–18.PubMedGoogle Scholar
  64. 64.
    Eisenberg PR, Barzilai B, Perez JE (1984) Noninvasive detection by Doppler echocardiography of combined septal rupture and mitral regurgitation in acute myocardial infarction. J Am Coll Cardiol 4: 617–620.Google Scholar
  65. 65.
    Hagen PT, Scholz DG, Edwards WP (1984) Incidence and size of patent foramen ovale during the first 10 decades of life: An autopsy study of 965 normal hearts. Mayo Clin Proc 59: 17–20PubMedGoogle Scholar
  66. 66.
    Morris AL, Donen M (1978) Hypoxia and intracardiac right-to left shunt: Complicating inferior myocardial infarction with right ventricular extension. Arch Intern Med 138: 1405– 1406.Google Scholar
  67. 67.
    Rietveld AP, Merrman L, Essed CE, Trimbos JB, Hagemeyer F (1983) Right to left shunt, with severe hypoxemia, at the atrial level in a patient with hemodynamically important right ventricular infarction. J Am Coll Cardiol 2: 776–779.PubMedCrossRefGoogle Scholar
  68. 68.
    Meister SG, Grossmann W, Dexter L, Dalen JE (1972) Paradoxical embolism: Diagnosis during life. Am J Med 53: 292–298.PubMedCrossRefGoogle Scholar
  69. 69.
    Manno BV, Bemis CE, Carver J, Mintz GS (1983) Right ventricular infarction complicated by right to left shunt. J Am Coll Cardiol: 554–557.Google Scholar
  70. 70.
    Bansal RC, Marsa RJ, Holland D, Bechler C, Gold PM (1985) Severe hypoxemia due to shunting through a patent foramen ovale: A correctable complication of right ventricular infarction. J Am Coll Cardiol 5: 188–192.PubMedCrossRefGoogle Scholar
  71. 71.
    Weyman ES, Peskoe SM, Williams ES, Dillon JC, Feigenbaum H (1976) Detection of left ventricular aneurisms by cross-sectional echocardiography. Circulation 54: 936–944.PubMedGoogle Scholar
  72. 72.
    Visser CA, Kan G, David GK, Lie KI, Durrer D (1982) Echocardiographic-cineangio- graphic correlation in detecting left ventricular aneurysm: A prospective study of 422 patients. Am J Cardiol 50: 337–340.PubMedCrossRefGoogle Scholar
  73. 73.
    Baur HR, Daniel JA, Nelson RR (1982) Detection of left ventricular aneurysm on two- dimensional echocardiography. Am J Cardiol 50: 191–196.PubMedCrossRefGoogle Scholar
  74. 74.
    Arvan S, Badillo P (1985) Contractile properties of the left ventricle with aneurysm. Am J Cardiol 55: 338–341.PubMedCrossRefGoogle Scholar
  75. 75.
    Visser CA, Kan G, Meltzer RS, Koolen JJ, Dunning AJ (1986) Incidence, timing and prognostic value of left ventricular aneurysm formation after myocardial infarction: A prospective, serial echocardiographic study of 158 patients. Am J Cardiol 57: 729–732.PubMedCrossRefGoogle Scholar
  76. 76.
    Barrett MJ, Charuzi Y, Corday E (1980) Ventricular aneurysm: Cross-sectional echocardiographic approach. Am J Cardiol 46: 1133–1137.PubMedCrossRefGoogle Scholar
  77. 77.
    Visser CA, Kan G, Meltzer RS, Moulyn AC, David GK, Dunning AJ (1985) Assessment of left ventricular aneurysm resectability by two-dimensional echocardiography. Am J Cardiol 56: 857–860.PubMedCrossRefGoogle Scholar
  78. 78.
    Asinger RW, Mikell FL, Sharma B, Hodges M (1981) Observations on detecting left ventricular thrombus with two-dimensional echocardiography: Emphasis on avoidance of false positive diagnosis. Am J Cardiol 47: 145–156.PubMedCrossRefGoogle Scholar
  79. 79.
    Visser CA, Kan G, David GK, Lie KI, Durrer D (1983) Two-dimensional echocardiography in the diagnosis of left ventricular thrombus. Chest 2: 228–232.CrossRefGoogle Scholar
  80. 80.
    Visser CA, Kan G, Lie KI, Durrer D (1983) Left ventricular thrombus following acute myocardial infarction: A prospective serial echocardiographic study of 96 patients. Eur Heart J 4: 333–337.PubMedGoogle Scholar
  81. 81.
    Weinreich DJ, Burke JF, Pauletto FJ (1984) Left ventricular mural thrombi complicating acute myocardial infarction. Ann Int Med 100: 789–794.PubMedGoogle Scholar
  82. 82.
    Stratton JR, Lighty GW, Pearlman AS, Ritchie JL (1982) Detection of left ventricular thrombus by two-dimensional echocardiography: Sensitivity, specificity and causes of uncertainly. Circulation 6: 156–166.CrossRefGoogle Scholar
  83. 83.
    Van Meurs-van Woezik H, Meltzer RS, Brand M vd, Essed CE, Michels RHM, Roelandt J (1980) Superiority of echocardiography over angiocardiography in diagnosing a left ventricular thrombus. Chest 3: 321–323.Google Scholar
  84. 84.
    Ezekowitz MD, Wilson DA, Smith EO, Burow RD, Harrison LH, Parker DE, Elkins RC, Peyton M, Taylor FB (1982) Comparison of indium-Ill platelet scintigraphy and two- dimensional echocardiography in the diagnosis of left ventricular thrombi. N Engl J Med 306: 1509–1513.PubMedCrossRefGoogle Scholar
  85. 85.
    Spirito P, Bellotti P, Chiarella F, Domenicucci S, Sementa A, Vecchio C (1985) Prognostic significance and natural history of left ventricular thrombi in patients with acute anterior myocardial infarction: A two-dimensional echocardiographic study. Circulation 72: 774–780.PubMedCrossRefGoogle Scholar
  86. 86.
    Visser CA, Kan G, Meltzer RS, Lie KI, Durrer D (1984) Long-term follow-up of left ventricular thrombus after acute myocardial infarction. Chest 86: 532–536.PubMedCrossRefGoogle Scholar
  87. 87.
    Johannessen KA, Nordrehaug JE, Lippe G vd (1984) Left ventricular thrombosis and cerebrovascular accident in acute myocardial infarction. Br Heart J 51: 553–556.PubMedCrossRefGoogle Scholar
  88. 88.
    Asinger RW, Mikell FL, Elsperger J, Hodges M (1981) Incidence of left ventricular thrombosis after acute transmural myocardial infarction. N Engl J Med 305: 297–302.PubMedCrossRefGoogle Scholar
  89. 89.
    Bhatnagar SK, Hudak A, Al-Yusuf AR (1985) Left ventricular thrombosis, wall motion abnormalities, and blood viscosity changes after first transmural anterior myocardial infarction. Chest 88: 40–44.PubMedCrossRefGoogle Scholar
  90. 90.
    Visser CA, Kan G, Meltzer RS, Dunning AJ, Roelandt J (1985) Embolic potential of left ventricular thrombus after myocardial infarction: Two-dimensional echocardiographic study of 119 patients. J Am Coll Cardiol 5: 1276–1280.PubMedCrossRefGoogle Scholar
  91. 91.
    Metzer RS, Visser CA, Kan G, Roelandt J (1984) Two-dimensional echocardiographic appearance of left ventricular thrombi with systemic emboli after myocardial infarction. Am J Cardiol 53: 1511–1513.CrossRefGoogle Scholar
  92. 92.
    Lloret RL, Cortada X, Bradford J, Metz MN, Kinney EL (1985) Classification of left ventricular thrombi by their history of systemic embolization using pattern recognition of two- dimensional echocardiograms. Am Heart J 110: 761–765.PubMedCrossRefGoogle Scholar
  93. 93.
    Come PC (1983) Transient right atrial thrombus during acute myocardial infarction: Diagnosis by echocardiography. Am J Cardiol 51: 1228–1229.PubMedCrossRefGoogle Scholar
  94. 94.
    Stowers SA, Leiboff RH, Wasserman AG, Katz RJ, Bren GB, Hsu I (1983) Right ventricular thrombus formation in association with acute myocardial infarction: Diagnosis by 2-dimensional echocardiography. Am J Cardiol 52: 912–913.PubMedCrossRefGoogle Scholar
  95. 95.
    Tenet W, Missri J, Clark B, Jaskolka D (1985) Right ventricular thrombus complicating right ventricular infarction. J Cardiovasc Ultrasound 4: 197 - 199.Google Scholar

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© Kluwer Academic Publishers 1991

Authors and Affiliations

  • John H. Smyllie
  • Patricia E. Assmann
  • George R. Sutherland
  • Alan G. Fraser
  • Jos R. T. C. Roelandt

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