Miokardna kontrastna ehokardiografija pri akutnem miokardnem infarktu z dvignjeno veznico ST
Myocardial contrast echocardiography in acute ST elevation myocardial infarction

slovenian

2004

volume 73, issue 7-8

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Background. Tissue myocardial perfusion is an important prognostic factor in patients after acute ST elevation myocardial infarction (STEMI) and early reperfusion treatment. Simple clinical methods for tissue perfusion assessmentare unreliable. Myocardial contrast echocardiography (MCE) was developed recently as an upgrade of standard ultrasound examination of the heart. By using gas microbubbles as a contrast agent, it enables a direct visualization of myocardial microvascular integrity and tissue perfusion. Methods. Two case reports of MCE use in patients with STEMI are presented. Thefirst patient was treated with systemic thrombolysis, MCE study was performed four hours after it has been finished. The second patient was treated with primary percutaneous transluminal coronary angioplasty (PTCA) in Clinical centre. MCE was performed on the second day, after the patient had been transferred to our hospital. Results. In both patients MCE showed abnormal tissue perfusion that was conclusive with incomplete reperfusion. In the first patient subacute rupture of free left ventricular wall with cardiac tamponade and death occurred on the next day. The location of the rupture could have been the area of myocardium with unsuccessful reperfusion. In the second patient the area of incomplete reperfusion was connected with a permanent functional damage. Conclusions. MCE is a non-invasive method for assessing tissue myocardial perfusion. In clinical practice it can be used in patients with STEMI treated with systemic thrombolysis or PTCA. MCE offers an excellent tool for judging reperfusion success and has important implications on future treatment of those patients.

15.05.2023