Can a bedside echocardiogram help rule out STEMI in patients with suspicious ECG ?

Can a bedside echocardiogram help rule out STEMI in patients with suspicious ECG?No, it can’t  (Though, it may be tempting to use a rapid echo to look for wall motion defect to rule out ACS ) If your answer was No, probably you don’t need to read any further in this post. Diagnosis of STEMI* is based onClinicalECGBio-Markers *Please note, two of the most popular investigations namely Echo and Coronary angiogram are missing in the list.Middle-aged man with  chest pain.  Can an echocardiogram help you confirm  STEMI here? Most likely not. It may still be a evolving STEMI. But, observation, serial ECGs, and Troponin is the answer. (ECG -Source  /Representative)Though, echocardiography, a great noninvasive imaging tool at the point of care, it stands almost helpless in the diagnosis of the commonest cardiac emergency ie ACS. It can be called as mother of all paradox even visualizing the myocardium directly with high-quality imaging will not tell you, whether there is ongoing ACS or not. Relying on wall motion defects without diagnostic ECG changes to diagnose STEMI  can be misleading for the simple reason, both unstable angina and old MI can be a 100 % confounding effect. Similarly, absence of WMA doesn’t rule out an evolving STEM(Apart from the bizarre behavior of   Ischemic cascade,  In the early hours only subendocardial wall stress is noted, that is not good enough to cause visible WMA)Role of CAG ...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Uncategorized diagnostic criteria for stemi gls in stemi role of echocardiography in diagnosis of acs stemi nstemi wall motion defect in stemi by echo Source Type: blogs

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