IMMEDIATE DIAGNOSIS OF ACUTE MYOCARDIAL-INFARCTION BY TWO-DIMENSIONAL ECHOCARDIOGRAPHY
IMMEDIATE DIAGNOSIS OF ACUTE MYOCARDIAL-INFARCTION BY TWO-DIMENSIONAL ECHOCARDIOGRAPHY
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DOI：
10.1161/01.cir.65.2.323
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发表时间：
1982-01-01
期刊：
影响因子：
37.8
通讯作者：
PAULETTO, FJ
中科院分区：
文献类型：
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作者：
HOROWITZ, RS;MORGANROTH, J;PAULETTO, FJ
为了明确便携式二维超声心动图 (2-D echo) 在急性胸痛综合征即时诊断中的作用，对 80 名连续患者进行了研究。 65 例 (81%) 获得了充分的二维回波研究。 33 名患者有透壁或非透壁急性心肌梗死 (AMI) 的临床证据，其中 18 名患者的初始心电图无法诊断。 32 人没有临床 AMI。 33 名临床 AMI 患者中，有 31 名 (94%) 在初始二维回声中出现局部室壁运动异常；另外 2 例患有无并发症的非跨壁 AMI，其中一名仅通过心电图诊断，另一名则通过心电图和 CK[肌酸激酶]-MB 同工酶中度升高诊断。在 32 名无临床 AMI 的患者中，37 名患者在初始二维回波中具有正常的局部室壁运动，并且在住院期间没有人出现并发症（严重心律失常、反复疼痛、心力衰竭或死亡）。相反，36 名初始二维回声局部室壁运动异常的患者中有 10 名出现了并发症（P < 0.05）。对于急性胸痛综合征患者，初始二维回声显示无局部室壁运动异常，表明此类患者在住院期间不会出现 AMI 或临床并发症。具有局部室壁运动异常的初始二维回波可识别出可能患有 AMI 和重要心脏并发症的高危患者群体，因此可能会受益于入住重症监护病房。
To define the role of portable 2-dimensional echocardiography (2-D echo) in the immediate diagnosis of acute chest pain syndrome, 80 consecutive patients were studied. Adequate 2-D echo studies were obtained in 65 (81%). Thirty-three patients had clinical evidence of transmural or nontransmural acute myocardial infarction (AMI), 18 of whom had nondiagnostic initial ECG. Thirty-two did not have a clinical AMI. Thirty-one of the 33 (94%) patients with clinical AMI had regional wall motion abnormalities on the initial 2-D echo; the other 2 had uncomplicated nonstransmural AMI, diagnosed only by ECG in one and by ECG and moderate elevation of CK[creatine kinase]-MB isoenzyme in the other. Of the 32 patients without clinical AMI, 37 had normal regional wall motion on the initial 2-D echo and none had a complication (severe arrhythmia, recurrent pain, heart failure or death) during the hospital course. Conversely, 10 of the 36 patients with initial 2-D echo regional wall motion abnormalities had a complication (P < 0.05). In patients with acute chest pain syndrome, an initial 2-D echo that shows no regional wall motion abnormality suggests that such patients will not develop an AMI or clinical complication during the hospital course. An initial 2-D echo with regional wall motion abnormality identifies a high-risk group of patients who are likely to have AMI and important cardiac complications and may, therefore, benefit from admission to an intensive care unit.