Early Diagnosis of Complications of ST-elevation Myocardial Infarction with 2D Echocardiography

Introduction: 2D echo is a non-invasive, rapid, investigation that enables us to visualize the heart directly in real-time using ultrasound and can help in such situations in diagnosing AMI by detecting any regional wall motion abnormality. The diagnosis of ST-elevation in myocardial infarction (STEMI) is usually based on patient’s history and ECG findings, but it should be taken into account that patients may present with atypical symptoms, also it takes cardiac enzymes some time to elevate above the normal range after the onset of chest pain. Materials and methods: A total of 100 diagnosed patients with the first episode of acute ST-elevation myocardial infarction who reported in the emergency were included in the study and who have given written informed consent. On admission, patients with typical or atypical ischemic symptoms and ECG changes of ST-segment elevation of > 0.1 mV (1 mm) in leads 2, 3, avF, V4, V5, V6, 1, and avL, and in leads V2, V3 > 0.2 mV (2 mm) in males > 40 years, > 0.25 mV in males 0.15 mV in females, in 2 contiguous leads were diagnosed as acute STEMI. Observation and results: In our study, mechanical complications of AMI were detected on 2D echo, of which, mitral regurgitation was found in 23 patients (23%), the ventricular septal rupture was found in 3 patients (3%), ventricular free wall rupture in 2%, papillary muscle rupture in 11%, pericardial effusion was found in 13%, and LV clot was found in 11% patients. Conclusion: Acute myocardial infarction is seen more commonly in the age-group of 61–70 years and it is more common among males. Killip classification of patients has prognostic value and helps in accessing the severity of myocardial infarction. Mechanical complications of AMI can be detected by 2D echo and can aid accordingly in treatment.