Does Echocardiography Aid in the Management of Acute Myocardial Infarction?

Abstract

The development and refinement of echocardiographic techniques and the availability of reasonably portable equipment has made the use of cardiac ultrasound in the acute care setting feasible. In most parts of the world, acute manifestations of coronary artery disease, such as out-of-hospital ventricular fibrillation with unexpected collapse and acute myocardial infarction, represent the majority of admissions to a coronary care unit. While clinical information, including changes in the electrocardiogram and cardiac enzymes, frequently provide diagnostic and prognostic information, these tests and the clinical examination and history may be inconclusive or may not afford adequate specificity to discriminate among patients with a complicated clinical course. To attempt to explore the possible contribution of the echocardiographic examination in this clinical setting, we performed two-dimensional echocardiography on 48 patients admitted to the coronary care unit because of suspected acute myocardial infarction or following resuscitation for unexpected out-of-hospital cardiac arrest. Repeat examinations were performed during the hospitalization. The observations resulting from these studies and the relationship to other clinical information, hospital course and survival are reported.