Bedside Use of Speckle Tracking Echocardiography in the Emergency Department to Identify Acute Myocardial Infarction

Abstract

Background: Rapid diagnosis of acute myocardial infarction (AMI) in the emergency department (ED) is often hindered by the limitations of the electrocardiogram (ECG). Speckle tracking echocardiography (STEch) is a semiautomated, computer-assisted process that provides accurate detection of regional ventricular wall motion abnormalities and can be performed at the bedside by operators with limited experience.

Case reports: Two separate patients, each with history and ECG findings concerning for AMI, were evaluated using STEch performed by an emergency physician. Ventricular wall motion abnormalities found on STEch accurately reflected the findings of emergent cardiac catheterization, with one patient requiring urgent coronary artery revascularization and the other with no coronary artery occlusion. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: STEch is a novel, easy-to-use form of echocardiography that can be used in the ED to identify patients with AMI who would benefit from emergent revascularization.

Keywords: bedside echocardiography; emergency echocardiography; emergency ultrasound; myocardial infarction; speckle tracking echocardiography.