Abstract 2575: Abnormal Regional Right Ventricular Mechanics In Acute Myocardial Infarction Without Evidence Right Ventricular Involvement by Wall Motion Analysis or Electrocardiography

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Aurelio C Pinheiro ◽  
Hsin-Yueh Liang ◽  
Veronica L Dimaano ◽  
Patrick Eulitt ◽  
Mary Corretti ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Right Ventricular ◽  
Wall Motion ◽  
Tissue Doppler ◽  
Ventricular Mechanics ◽  
Conventional Echocardiography ◽  
Worse Prognosis ◽  
Strain Echocardiography

Background: Right ventricular (RV) involvement portends a worse prognosis in acute myocardial infarction (AMI). Tissue Doppler strain echocardiography (TDSE) allows accurate, sensitive quantitation of RV mechanics. We compared TDSE to echocardiographic wall motion abnormality (WMA) and electrocardiography (EKG) in detecting RV dysfunction in AMI. Methods and Results: We prospectively imaged 55 subjects (40 consecutive patients with AMI and 15 healthy controls). All patients had troponin profiles, coronary angiography, and echocardiography and TDSE. Coronary artery stenosis >70% was considered significant. We excluded 7 AMI with multiple vessel disease. We separated the rest into those with left anterior descending related AMI (LAMI) and right coronary artery related AMI (RAMI). EKG revealed RV AMI in 1 patient. None had RV WMA. RV free wall base and mid-apical segments were analyzed separately. Systolic strain (sS) and systolic (SRs) and early diastolic (SRe) strain rates were lower in RAMI compared to controls with the predominant abnormality in the basal RV with preserved mid-apical mechanics. LAMI mechanics were similar to controls except for lower SRe. Conclusions: TDSE reveals significantly abnormal RV mechanics in RAMI in the absence of WMA or RV related EKG abnormality. TDSE offers a superior alternative to EKG and conventional echocardiography for RV evaluation in AMI.

scholarly journals Takotsubo Syndrome Associated with ST Elevation Myocardial Infarction

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Saad Ezad ◽  
Michael McGee ◽  
Andrew J. Boyle
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Wall Motion ◽  
Obstructive Coronary Artery Disease ◽  
Takotsubo Syndrome ◽  
St Elevation ◽  
Wall Motion Abnormalities ◽  
Artery Disease

Background. Takotsubo syndrome is a reversible heart failure syndrome which often presents with symptoms and ECG changes that mimic an acute myocardial infarction. Obstructive coronary artery disease has traditionally been seen as exclusion criteria for the diagnosis of takotsubo; however, recent reports have called this into question and suggest that the two conditions may coexist. Case Summary. We describe a case of an 83-year-old male presenting with chest pain consistent with acute myocardial infarction. The ECG demonstrated anterior ST elevation with bedside echocardiography showing apical wall motion abnormalities. Cardiac catheterisation found an occluded OM2 branch of the left circumflex artery with ventriculography confirming apical ballooning consistent with takotsubo and not in the vascular territory supplied by the occluded epicardial vessel. Repeat echocardiogram 6 weeks later confirmed resolution of the apical wall motion abnormalities consistent with a diagnosis of takotsubo. Discussion. This case demonstrates the finding of takotsubo syndrome in a male patient with acute myocardial infarction. Traditionally, this would preclude a diagnosis of takotsubo; however, following previous reports of takotsubo in association with coronary artery dissection and acute myocardial infarction in female patients, new diagnostic criteria have been proposed which allow the diagnosis of takotsubo in the presence of obstructive coronary artery disease. This case adds to the growing body of literature that suggests takotsubo can coexist with acute myocardial infarction; however, it remains to be elucidated if it is a consequence or cause of myocardial infarction.

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