Urgent Myocardial Revascularization in Non ST-Segment Elevation Acute Myocardial Infarction Guided by Speckle Tracking Echocardiography: A Challenging Interventional Decision-Making

Cardiology. 2018;140(4):222-226. doi: 10.1159/000488934. Epub 2018 Aug 23.

Abstract

A 68-year-old man with a non-ST elevation myocardial infarction (NSTEMI) presented with a low risk profile indicating invasive revascularization within 72 h. However, left ventricular (LV) global longitudinal strain (GLS) calculated by two-dimensional speckle tracking echocardiography (2D-STE) in the Emergency Room showed substantial myocardial infarction. Therefore, urgent reperfusion therapy was decided and delivered within 30 min from hospital admission. LV GLS fully recovered after the invasive procedure and the final infarct size was 7%. This case shows that very early revascularization in NSTEMI patients can be guided by 2D-STE and might be considered for those patients with substantial LV myocardial infarction.

Keywords: Acute myocardial infarction; Global longitudinal strain; Speckle tracking echocardiography.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Decision Making
  • Echocardiography / methods
  • Electrocardiography
  • Humans
  • Male
  • Myocardial Infarction
  • Myocardial Revascularization* / methods
  • Non-ST Elevated Myocardial Infarction / diagnostic imaging*
  • Non-ST Elevated Myocardial Infarction / surgery*
  • Time Factors
  • Treatment Outcome