Echocardiographic features of myocardial rupture after acute myocardial infarction on emergency echocardiography.

IF 1.9 Q2 EMERGENCY MEDICINE Clinical and Experimental Emergency Medicine Pub Date : 2023-12-01 Epub Date: 2023-06-02 DOI:10.15441/ceem.23.037
Byung Wook Lee, Yong Sung Cha, Sung Oh Hwang, Yoon-Seop Kim, Sun Ju Kim
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Abstract

Objective: Myocardial rupture is a fatal complication of acute myocardial infarction (AMI). Early diagnosis of myocardial rupture is feasible when emergency physicians (EPs) perform emergency transthoracic echocardiography (TTE). The purpose of this study was to report the echocardiographic features of myocardial rupture on emergency TTE performed by EPs in the emergency department (ED).

Methods: This was a retrospective and observational study involving consecutive adult patients presenting with AMI who underwent TTE performed by EPs in the ED of a single academic medical center from March 2008 to December 2019.

Results: Fifteen patients with myocardial rupture, including eight (53.3%) with free wall rupture (FWR), five (33.3%) with ventricular septal rupture (VSR), and two (13.3%) with FWR and VSR, were identified. Fourteen of the 15 patients (93.3%) were diagnosed on TTE performed by EPs. Diagnostic echocardiographic features were found in 100% of the patients with myocardial rupture, including pericardial effusion for FWR and a visible shunt on the interventricular septum for VSR. Additional echocardiographic features indicating myocardial rupture were thinning or aneurysmal dilatation in 10 patients (66.7%), undermined myocardium in six patients (40.0%), abnormal regional motions in six patients (40.0%), and pericardial hematoma in six patients (40.0%).

Conclusion: Early diagnosis of myocardial rupture after AMI is possible using echocardiographic features on emergency TTE performed by EPs.

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急诊超声心动图显示急性心肌梗死后心肌破裂的超声心动图特征。
目的:心肌破裂是急性心肌梗死(AMI)的致命并发症:心肌破裂是急性心肌梗死(AMI)的致命并发症。如果急诊医生(EP)能进行急诊经胸超声心动图(TTE)检查,就能早期诊断心肌破裂。本研究的目的是报告急诊科(ED)的急诊医师在急诊经胸超声心动图检查中发现的心肌破裂的超声心动图特征:这是一项回顾性观察研究,涉及2008年3月至2019年12月期间在一家学术医疗中心急诊科由急诊科医师进行TTE检查的连续成人AMI患者:共发现15例心肌破裂患者,其中8例(53.3%)为游离壁破裂(FWR),5例(33.3%)为室间隔破裂(VSR),2例(13.3%)为FWR和VSR。15 名患者中有 14 名(93.3%)是由 EPs 进行 TTE 诊断的。100%的心肌破裂患者都具有诊断性超声心动图特征,包括FWR患者的心包积液和VSR患者室间隔上的可见分流。表明心肌破裂的其他超声心动图特征包括:10 名患者(66.7%)心肌变薄或动脉瘤样扩张;6 名患者(40.0%)心肌受损;6 名患者(40.0%)区域运动异常;6 名患者(40.0%)心包血肿:结论:急诊心电图医生通过急诊 TTE 超声心动图特征可早期诊断急性心肌梗死后的心肌破裂。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
2.80
自引率
10.50%
发文量
59
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