Echocardiography in acute myocardial infarction

Abstract

Echocardiography is valuable in all patients with acute myocardial infarction for diagnosis, differential diagnosis, functional assessment, detection of complications, and/or prognosis. The value of echocardiography as a diagnostic tool is highest in patients with acute coronary syndrome with atypical clinical presentation, nondiagnostic electrocardiogram, and/or normal or only slightly increased cardiac enzymes. The collected information, whether assessed quantitatively or qualitatively, is of incomparable value for accurate estimation of risk and for guiding management, especially in hemodynamically unstable patients. Initial left ventricular volumes, wall motion score index, infarct zone viability, and diastolic filling carry important prognostic information. It should be emphasized that echocardiographic examination in unstable patients with ongoing chest pain in the emergency setting is a highly demanding procedure that requires both excellent technical skills to obtain adequate images in a stressful environment and the ability to interpret findings quickly and accurately. Of note, echocardiographic examination must not induce unnecessary delays in triage of patients to reperfusion therapy. © 2023 CRC Press.