Friday, February 19, 2016

Time onset of Echo detection after MI ? -DrSudeepKC

How long after coronary artery occlusion can echocardiography detect wall-motion abnormalities?

(A) Within a few heartbeats
(B) 5 to 10 min
(C) 30 min
(D) 1 h
(E) 2 to 4 h

The answer is A. Soon after the onset of myocardial ischemia, muscle contraction is impaired. This may manifest on echocardiography as a wall-motion abnormality.

Experimentally, hypokinesis, akinesis, or dyskinesis can be seen within a few heartbeats after coronary occlusion. In selected patients in the critical care unit, echocardiography has a sensitivity greater than 70 percent in AMI.

 In studies of ED patients, where prevalence of AMI is lower and prevalence of coronary artery disease is higher, echo has been shown to be sensitive but not specific.

Echocardiography is most useful in patients with cardiogenic shock to diagnose anatomic complications that may be amenable to surgical correction (i.e., septal or mitral ruptures).


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