急诊超声心动图评价心脏功能

目的　评价超声心动图在急诊心功能不全的分型和急性心肌梗死的临床诊断价值及可行性 .方法　选择急诊就诊的心功能不全 (10 9例 )和第一次急性心肌梗死 (12例 )入住ICU的患者 12 1(男 6 3,女 5 8)例 ,在就诊即刻至 2 4h内进行超声心动图评价心脏左室收缩、舒张功能以及左室局部收缩功能 .结果　 5例超声声窗差排除出本研究组 (4 .1% ) ,116例 (95 .9% )进行分析 .急诊就诊的心力衰竭的大多数病因是高心病、肺心病和冠心病 ,分别占 48% ,19%和 2 1% .单纯舒张性心力衰竭 16例 ,占 15 % ,仅凭临床未能作出单纯舒张性心力衰竭的诊断 .超声心动图可检测急性心肌梗死的左室局部收缩功能异常 ,7例急性心肌梗死 RWMSI大于 1,5例在 6h内未检出节段性室壁运动异常 .结论　超声心动图对于急诊就诊的心力衰竭的分型及诊治具有重要作用 ,特别是诊断单纯舒张功能不全具有不可替代的价值 ;有助评价急性心肌梗死左室局部收缩功能 ,但是在溶栓的最佳 6 h内不能增强诊断及溶栓治疗的信心 .超声心动图在急诊科用于心功能和急性心肌梗死的评价是必要的和可行的

Assessment of left ventricular function by echocardiography in the emergency room

AIM To investigate the valuability and feasibility of echocardiography for left ventricular function assessment in the patients admitted to the emergency room. METHODS 121 consecutive patients with heart failure (109 cases) and first AMI (12 cases) underwent two dimensional & Doppler echocardiography of global left ventricular systolic, diastolic function and regional wall motion abnormality. during 24 hours. RESULTS Of 116 patients (95.9%), 104 cases with heart failure and 12 cases with the first AMI were studied. The main causes of heart failure were hypertensive heart disease (HHD), ischemia heart disease (IHD) and pulmonary heart disease (PHD), respectively 48%, 19% and 21%. Of the heart failure patients, 16 cases (15%) were the pure diastolic dysfunction without systolic dysfunction, which had not been diagnosed clinically. The regional wall motion abnormality in the patients with AMI was detected by echocardiography in 7 cases of AMI with RWMSI>1 after 6 h but not in 5 cases within 6 h. CONCLUSION It is valuable and feasibile for evaluation of left ventricular function by echocardiography in the patients admitted to the emergency room, especially for the diagnosis of pure diastolic dysfunction. However regional wall motion abnormality evaluated by echocardiography may not increase the confidence of thrombolisis and diagnosis of AMI during 6 h.