Point-of-care ultrasound in the evaluation of STEMI patients

Abstract

Background: ST-elevation myocardial infarction (STEMI) remains a leading cause of morbidity and mortality globally. Early risk stratification and detection of complications are critical for optimizing patient outcomes. Point-of-care ultrasound (POCUS) has emerged as a valuable bedside tool in the acute evaluation of STEMI patients.

Objectives: To explore the role of POCUS in the early assessment of STEMI patients, focusing on its diagnostic and prognostic utility.

Methods: A comprehensive review of current literature was conducted, examining the application of POCUS in STEMI.

Results: Lung ultrasound (LUS) enables rapid detection of pulmonary congestion through the identification of B-lines, offering superior sensitivity compared to traditional methods. Left ventricular outflow tract velocity-time integral (LVOT-VTI) provides a quantitative assessment of stroke volume and cardiac output, aiding in the identification of low-flow states. Integrating these modalities enhances hemodynamic evaluation. Moreover, a systematic POCUS assessment may facilitate early detection of high-risk patients with acute heart failure or cardiogenic shock, as well as the identification of mechanical complications.

Conclusions: The incorporation of POCUS, specifically LUS and LVOT-VTI, into the early evaluation of STEMI patients enhances diagnostic accuracy and prognostic assessment. Future research should focus on standardizing protocols and evaluating the impact of POCUS-guided management on patient outcomes.

Keywords: LVOT-VTI; STEMI; acute heart failure; cardiogenic shock; lung ultrasound; point-of-care ultrasound.