Why the study?
Myocardial rupture is a fatal complication of AMI, and early diagnosis is feasible when emergency physicians perform emergency TTE in the emergency department.
What are the echocardiographic features of myocardial rupture after acute myocardial infarction on emergency TTE performed by emergency physicians?
What are the echocardiographic features of myocardial rupture after acute myocardial infarction on emergency TTE performed by emergency physicians?
Emergency transthoracic echocardiography performed by emergency physicians is highly effective for the early diagnosis of myocardial rupture after acute myocardial infarction.
Answers are grounded in this paper and cite their sources.
Supports EP-performed TTE for suspected post-MI rupture; leaves open prospective validation before routine adoption.
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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Lee et al. (2023) studied this question.
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