.
http://ehjcimaging.oxfordjournals.org/content/16/2/119
.
ACSs
Rest echocardiography
In acute ischaemic chest pain, the primary role of rest echocardiography is to assess the presence and extent of regional wall motion abnormalities, encountered in different types of myocardial injury (ischaemia, stunning, hibernation or necrosis). Echocardiography alone cannot distinguish between ischaemia and infarction; however, the absence of wall motion abnormalities, especially in patients with ongoing or prolonged chest pain (> 45 min), excludes major myocardial ischaemia. Of note, normal resting echocardiography cannot definitively rule out a transient episode of ischaemia, especially in patients with chest pain of short duration. In patients with suspected ACS, deformation imaging of the LV (strain and strain rate) is a potentially useful technique to reveal subtle wall motion abnormalities (including post-systolic shortening) when standard visual assessment of wall motion fails to detect any abnormalities.26,27 It is important to remember that segmental wall motion abnormalities are not synonymous with ischaemia, and can also occur in other conditions, such as myocarditis, right ventricular (RV) pressure/volume overload states, LV pre-excitation, Takotsubo cardiomyopathy, left bundle branch block or in the presence of a paced rhythm. During the hospital stay, echocardiography is used to assess LV function.
.
.
http://ehjcimaging.oxfordjournals.org/content/11/6/501
.
.
É incrível como a ecocardiografia já tem ferramentas confiáveis para uso no paciente de pronto socorro e que são de baixo custo e alta confiabilidade.
.
O exame do paciente com dor torácica na emergência não pode mais analisar apenas a fração de ejeção e paredes.
.
O uso do Strain é obrigatório.
.
Repetimos aqui que o método de imagem depende de um defensor examinador.
As ferramentas estão à disposição do ecocardiografista. Basta ele estar disposto a dar uma resposta confiável usando a tecnologia.
.
Você está pronto?
.