Echocardiographic prediction of the site of coronary artery obstruction in acute myocardial infarction

Eur Heart J. 1987 Feb;8(2):116-23. doi: 10.1093/oxfordjournals.eurheartj.a062238.

Abstract

In 49 patients with acute myocardial infarction (AMI), the infarction topography was assessed by cross-sectional echocardiography and the location of coronary artery obstruction were correlated. A ventricular segmentation of 5 right and 16 left ventricular segments was used. The site of coronary obstruction was determined in 45 patients by coronary angiography and by necropsy in 4 patients. The exact location of the obstruction could not be found in 4 patients. The infarct related vessel was the left main artery in 1 patient, the left anterior descending artery (LAD) in 19, the left circumflex in 6 and the right coronary artery in 24. Specific segments were identified for each of the 3 coronary arteries: anteroseptal and anterior segments for LAD, right ventricular segments for the right coronary artery and basal anterolateral segment for the left circumflex. Specific segments (specificity 100%) were also identified for the principal coronary branches: basal anterior for the first anterior descending diagonal (sensitivity 71%), basal anteroseptal for the first septal perforator (83%), middle anterior for the second diagonal (100%), middle anteroseptal for the second septal (89%), basal posteroseptal for a dominant right coronary artery (89%), right ventricular anterolateral segment for the right ventricular marginal branch (83%). Echocardiographic identification of the topography of AMI can be useful in recognizing the infarct-related vessel and identifying the site of coronary artery obstruction.

MeSH terms

  • Adult
  • Aged
  • Coronary Disease / pathology*
  • Coronary Thrombosis / pathology*
  • Coronary Vessels / pathology
  • Diagnosis, Differential
  • Echocardiography*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / pathology*
  • Recurrence