RESUMO
Echocardiography remains the best non invasive tool for identifying patients who may have impaired filling of the left ventricle or diastolic dysfunction. The most accurate echocardiographic modality that reveals normal and abnormal diastolic function is doppler tissue imaging (DTI), and more recently, strain imaging. The complex and user intense DTI modality traces the motion of the mitral annulus during left ventricular filling revealing diastolic impairment. The aortic annulus with its attached aortic root moves simultaneously with the rigidly attached mitral annulus. M-mode traced motion of the aortic root in diastole mimics the motion of the mitral annulus and thus should depict left ventricular diastolic function. Hypertensive patients and normal subjects were screened for left ventricular diastolic dysfunction (LVDD) with DTI, mitral inflow velocities (MIF) and M-mode aortic root motion (M-MARM). The easily obtained and less complex M-MARM was as accurate as DTI in detecting and ruling out regional
Assuntos
Aorta/diagnóstico por imagem , Ecocardiografia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Aorta/fisiopatologia , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiopatologia , Velocidade do Fluxo Sanguíneo/fisiologia , Diástole/fisiologia , Ecocardiografia Doppler , Ecocardiografia Doppler em Cores , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Hipertensão/diagnóstico por imagem , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/fisiopatologia , Processamento de Imagem Assistida por Computador , Programas de Rastreamento , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Disfunção Ventricular Esquerda/fisiopatologiaRESUMO
A 43-year-old caucasian female without prior history or family history of cardiac disease presented to a community hospital with severe chest pain and electrocardiographic evidence of an acute left anterior descending (LAD) territory infarction. Duringtransferto ourtertiaryfacility, the patient had a cardiac arrest and was cardioverted in the ambulance. After arrival, the patient suffered a second cardiac arrest, was given CPR, cardioverted, intubated and given volume resuscitation. The patient was stabilized with vasopressors and was taken to the cardiac catherization (cath) lab where an intra-aortic balloon pump (IABP) was inserted. At catherization, the patient was found to have an acute left main coronary artery dissection and had evidence of cardiogenic shock. Prompt treatment including multiple stents, hypothermia protocol (HP), left ventricular assist device (LVAD) and multiple inotropic agents resulted in complete clinical recovery.