Why the study?
Does transesophageal echocardiography (TEE) improve the diagnosis of right atrial and right ventricular infarction compared to transthoracic echocardiography (TTE) in patients with posteroinferior LV acute MI?
Does transesophageal echocardiography (TEE) improve the diagnosis of right atrial and right ventricular infarction compared to transthoracic echocardiography (TTE) in patients with posteroinferior LV acute MI?
Transesophageal echocardiography provides superior diagnostic yield compared to transthoracic echocardiography for identifying right atrial and right ventricular infarction in the early stages of posteroinferior myocardial infarction.
TEE may enhance RV/RA infarction detection over TTE in inferior MI; hypothesis-generating, requiring prospective validation before practice change.
In order to compare the results of transesophageal echocardiography (TEE) in diagnosis of right atrial (RA) and right ventricular (RV) infarction with those of transthoracic echocardiography (TTE), 11 patients admitted to the coronary care unit with the diagnosis of posteroinferior left ventricular (LV) acute myocardial infarction (MI) and electrocardiographic suspicion of extension to RV were studied. In two of the 11 patients, RA infarction was identified on the basis of akinesis of the RA free wall, dilatation of the atrial cavity, spontaneous echo contrast, mural thrombosis, and poor atrial contribution to RV filling. In all 11 patients, RV infarction was determined by akinesis of one or more segmental regions, dilatation of the cavity in four patients, and tricuspid regurgitation in seven. Only six cases of RV infarction were diagnosed with TTE. The findings indicate that TEE provides additional information to TTE for determining RA and RV infarction during the early stages of MI.
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Gómez-Villalobos et al. (1995) studied this question.
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