부산대학교 도서관

Acute myocardial infarction (AMI or heart attack) results from an interruption of the blood flow through the coronary arteries, which deprives the heart muscle of oxygen and nutrients. If prolonged, this deprivation can cause permanent, severe damage to the heart. In the short term, AMI-related cardiogenic shock (inability of the heart to pump sufficient blood to maintain bodily functions) carries with it a death rate of almost 85 percent. In many cases, this cardiac dysfunction may result from rupture of the ventricular septum (the wall separating the left and right ventricles), or from a lesion of a valve regulating the flow of blood through the various chambers of the heart. Rapid diagnosis of the exact nature of AMI-related cardiogenic shock is crucial to successful treatment. Standard diagnostic procedures utilize two-dimensional ultrasound imaging (echocardiography) techniques. To evaluate the utility of Doppler color flow imaging (a diagnostic technique for monitoring the rate of blood flow through vessels, among other things), 43 AMI patients with unexplained hypotension (low blood pressure) or heart murmur occurring during AMI recovery were subjected to both two-dimensional echocardiography and Doppler color flow imaging. The diagnoses obtained were verified either during surgery, at autopsy, or by angiographic imaging. Doppler imaging successfully correctly identified the 12 confirmed ventricular septal or mitral valve defects (100 percent sensitivity), whereas the optimal combination of two-dimensional echocardiographic predictive criteria yielded only 7 correct diagnoses (58 percent sensitivity). The use of Doppler imaging can eliminate the need for further time-consuming diagnostic testing to identify ventricular septal or mitral valve defects after AMI. (Consumer Summary produced by Reliance Medical Information, Inc.)