Two-dimensional speckle tracking-derived strain to distinguish acute coronary syndrome from a marked early repolarization in a patient with chest pain: a fancy gadget or a useful tool?
Echocardiography
; 31(2): E48-51, 2014 Feb.
Article
em En
| MEDLINE
| ID: mdl-24134415
ABSTRACT
BACKGROUND:
With a potential of detecting subtle myocardial injury, two-dimensional (2D) speckle tracking-derived strain could help to distinguish between ischemic and nonischemic ST-segment elevation. Little is known if limitations of strain imaging could prevent its applicability in acute cardiac care settings. CASE PRESENTATION We present a 56-year-old male with persistent ST-segment elevation in the inferolateral leads and suspected hypokinesia of the inferior wall. Semiautomated 2D speckle tracking strain analysis showed normal longitudinal peak systolic strain (LPSS) in all segments of the inferior wall, ruling out wall-motion abnormalities in this region. Stationary reverberations and spuriously low values of LPSS in the posterolateral wall required operator's expertise to distinguish pathological myocardial deformation from artifacts. Additional workup revealed that early repolarization pattern was mistaken for the inferior wall acute myocardial infarction in our patient.CONCLUSIONS:
Semiautomated quantification of regional left ventricular function by 2D speckle tracking echocardiography could facilitate decision making even in the emergency settings. Due to intrinsic limitations of this novel method, its actual clinical value in acute cardiac care settings may depend on the expertise of the operator and is yet to be determined.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Arritmias Cardíacas
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Dor no Peito
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Ecocardiografia Doppler
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Isquemia Miocárdica
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Síndrome Coronariana Aguda
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Técnicas de Imagem por Elasticidade
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Prognostic_studies
Limite:
Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article