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European Heart Journal 1987 8(2):116-123;
Copyright © 1987 by the European Society of Cardiology.
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© 1987 The European Society of Cardiology

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

L. A. PIERARD, M. SPRYNGER and J. CARLIER

Department of Cardiology, Institute of Medicine, University Hospital Liège, Belgium

Received 27 June 1985; revised 28 July 1986; .

Address for reprints. Luc A. Pierard, M.D., Universite de Liege, Service de Cardiologie, Boulevard de la Constitution, 59, B-4020 Liege, Belgium.

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 ventriclar 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.

Key Words: Acute myocardial infarction • coronary artery obstruction • cross-sectional echocardiography


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