RESUMO
The two-dimensional echocardiogram is an ideal noninvasive method for evaluation of the global and regional wall function of left ventricle particularly the apical part in the early phase of acute myocardial infarction. Apical dysfunction, right ventricular infarction, left ventricular thrombi can be detected by 2D-Echo. It is especially useful in the identification of a high risk group of patients with acute myocardial infarction, as a guideline for attempting different therapeutic modalities in these patients.
Assuntos
Ecocardiografia , Contração Miocárdica , Infarto do Miocárdio/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/fisiopatologia , Estudos ProspectivosRESUMO
We have non-invasively determined the extent of the acute myocardial insult shortly after admission in a large group of patients with acute myocardial infarction. There appeared a fairly sharp distinction between patients with low and high likelihood of in-hospital death and one year mortality on the basis of echocardiographic findings. The use of wall motion score index and ejection fraction in the prediction of short term mortality (in-hospital death) is good, but the prediction of long term mortality is not that good, since several patients survived up to one year even with high wall motion score index (greater than 2.2) or low ejection fraction (less than or equal to 35%) on admission. One-year survival is high up to 90 per cent in patients with low wall motion score index or high ejection fraction on admission.
Assuntos
Ecocardiografia , Contração Miocárdica , Infarto do Miocárdio/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , TailândiaRESUMO
In order to assess the diagnostic usefulness of EMB in patients with clinically suspected myocardial diseases, with and without heart failure or dysrhythmias, a prospective study was carried out in 84 consecutive patients. With EMB, the histological diagnosis was considered specific in 33 patients (39.3%), confirmative in 12 patients (14.3%) and negative in 39 patients (46.4%). It was found particularly useful in patients with unexplained heart failure and idiopathic dysrhythmias and in the differentiation between restrictive cardiomyopathy and constrictive pericarditis. The procedure can be safely performed with minimal morbidity and there was no mortality in the present study.
Assuntos
Cardiomiopatias/patologia , Endocárdio/patologia , Miocárdio/patologia , Adolescente , Adulto , Idoso , Biópsia , Cardiomiopatias/diagnóstico , Cardiomiopatia Restritiva/patologia , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pericardite Constritiva/patologia , Estudos ProspectivosRESUMO
In order to study the prevalence of myocarditis, EMB was carried out prospectively in 53 consecutive patients with various idiopathic dysrhythmias and efficacy of steroid therapy was evaluated. The patients consisted of 24 males and 29 females with ages ranging between 12 to 80 yrs. Histologic studies revealed myocarditis in 36 per cent. Steroid therapy resulted in good response in 14 of 18 patients (77.8%) with biopsy-proven myocarditis and in 5 of 17 patients (29.4%) with biopsy-negative but with clinically suspected myocarditis. The remaining patients did not have good response to steroid and there was 1 sudden death in each group.
Assuntos
Arritmias Cardíacas/complicações , Biópsia por Agulha , Miocardite/complicações , Prednisolona/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Endocárdio/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miocardite/diagnóstico , Miocardite/tratamento farmacológico , Miocárdio/patologia , Estudos ProspectivosAssuntos
Neoplasias Cardíacas/diagnóstico , Mixoma/diagnóstico , Adolescente , Adulto , Idoso , Criança , Ecocardiografia , Feminino , Átrios do Coração , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Prognostic factors in patients with acute myocardial infarction based on clinical and investigative data on admission were evaluated prospectively in 111 consecutive patients. Seventeen patients (15.3%) died during hospital stay. Age, a previous infarct, high Killip class, cardiomegaly, high serum concentrations of cardiac enzymes, a low ejection fraction, and a high wall motion score index correlated significantly with in-hospital mortality; whereas sex, risk factors, and pericardial effusion did not. Multivariate analysis showed that age and the wall motion score index were the best predictors of death in hospital. Wall motion detected by cross sectional echocardiography may reflect the extent of myocardial involvement. Age and wall motion score index predicted in-hospital mortality with a sensitivity of 76.5%, a specificity of 91.5%, and a predictive accuracy of 89.2%. Age and the wall motion score index can be determined on admission and are useful for identifying patients at high risk of cardiac death who might benefit from early intervention.