Diagnosis of Acute Coronary Occlusion in Patients with NonSTEMI by Point-of-Care Echocardiography with Speckle Tracking: a case report

Abstract Approximately 25% of patients with acute coronary occlusion present without diagnostic evidence of ST elevation on electrocardiogram (ECG). Traditionally, individuals that fall into this category have been detected by subsequent elevation of cardiac markers, and are diagnosed with NonSTEMI....

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Bibliographic Details
Published in:The American journal of emergency medicine 2016
Main Authors: Rowland-Fisher, Andrea, MD, Smith, Stephen, MD, Laudenbach, Andrew, MD, Reardon, Robert, MD
Format: Article
Language:English
Subjects:
Emergency
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Summary:Abstract Approximately 25% of patients with acute coronary occlusion present without diagnostic evidence of ST elevation on electrocardiogram (ECG). Traditionally, individuals that fall into this category have been detected by subsequent elevation of cardiac markers, and are diagnosed with NonSTEMI. Early detection and intervention of these individuals leads to lower six-month mortality, however, there has not been a good way to detect these individuals reliably. We report a case of a man presenting to the emergency department (ED) with a NonSTEMI who was found to have acute coronary occlusion detected by speckle tracking echocardiography performed by an emergency physician. This diagnosis led to early percutaneous intervention. This case highlights a novel use of ultrasound in the ED for detection of acute coronary occlusion when an ECG is non-diagnostic.
ISSN:0735-6757
DOI:10.1016/j.ajem.2016.02.017