[Expansion of the infarct area in anterior myocardial infarct: a short-term clinical and echocardiographic study].
Forty-five patients with a first anterior myocardial infarction were studied by serial two-dimensional echocardiographic examinations to evaluate the incidence, short-term evolution and clinical significance of infarct expansion. Infarct expansion was found in 26 patients (58%); in 22 cases it was detected at the first examination 24 hours after the onset of symptoms, while in the other 4 it developed later. In 20 (77%) patients expansion involved only the septal and apical regions, while in 6 (23%) it extended to the antero-lateral wall. Two out of 22 patients with early expansion died of cardiogenic shock; expansion of the infarcted area progressively increased in 10 of the remaining 20 patients and remained stable in the other 10. Compared to the patients without expansion those with expansion had a higher CK peak level, a greater number of pathological Q waves and a greater echocardiographic asynergy score; moreover, in-hospital mortality and the incidence of left ventricular failure were higher in the group with expansion (8% vs 0% and 54% vs 10% respectively). Thus our results show that in patients with anterior infarction, expansion is a frequent event which usually develops early and may have a progressive course; infarct expansion, especially when it is large and progressive, is associated with a high incidence of early left ventricular failure and has a poor prognostic significance.
Previtali
M
M
Divisione di Cardiologia, IRCCS-Policlinico S. Matteo e Sezione di Cardiologia, Pavia.
Lanzarini
L
L
Ferrario
M
M
Tortorici
M
M
Sist
M
M
Mussini
A
A
Montemartini
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004796:Clinical Enzyme Tests; D003402:Creatine Kinase / Q000097:blood; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging*; D011379:Prognosis; D012770:Shock, Cardiogenic / Q000401:mortality; D013997:Time Factors
D003402:Creatine Kinase
L'espansione dell'area infartuale nell'infarto miocardico anteriore: studio clinico ed ecocardiografico a breve termine.