[The value of two-dimensional echocardiography in the diagnosis of acute transmural primary infarctions].
The validity of two-dimensional echocardiography (2 DE) in the diagnosis of evolving myocardial infarction was assessed in 123 patients with a suspected acute myocardial infarction (chest pain for less than 4 hours). 84 patients developed a myocardial infarction, 39 did not. Detection and extent of a regional wall motion disorder in 2 DE were compared to ECG, enzymes, hemodynamics, coronary angiography and clinical data. The reliability of ECG and 2 DE in the diagnosis of acute myocardial infarction was found to be similar: sensitivity 89% for 2 DE, 96% for ECG; specificity 89% vs (= versus) 73%; positive predictive value 95% vs 89%; negative predictive value 79% vs 90%. This means that in most cases the ECG is a sufficient and reliable method in detecting or excluding acute myocardial infarction. Because of the equipment needed, the limited practicability and because of specific problems (distinction between new and old infarction), the 2 DE should be regarded as a supporting method to the ECG but not as an essential one in the diagnosis of acute myocardial infarction. The possible benefit of echocardiographic examination is the identification of high risk patients by non-invasive determination of the size of infarction. There was a significant correlation between the extent of wall motion disorder and the maximum CK levels as well as the incidence of cardiac complications such as hypotension, pulmonary congestion, and ventricular arrhythmias.
D000208:Acute Disease; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D009206:Myocardium / Q000201:enzymology
Stellenwert der zweidimensionalen Echokardiographie in der Diagnostik akuter transmuraler Erstinfarkte.