Echo Insights: Evaluating Ischemic Cardiomyopathy
Sonographers Corner
Thank you to Hendre van Rensburg for sending in this case with his thoughts and insights into evaluating ICM!
If you have an educational case that you think would benefit the echo community email us at case@echoimagingsolutions.com.
Ischemic cardiomyopathy is no stranger to any cardiac sonographer. You can encounter it in an acute setting (myocardial infarctions) or chronic (post-stenting or CABG). Echo plays a significant role in ischemic heart disease with both high sensitivity and specificity. Factors to consider include determining EF, any regional wall motion abnormalities (RWMA) present and most importantly, evaluating post-ischemic complications: ischemic mitral regurgitation, aneurysm formation, papillary muscle dysfunction, ischemic ventricular septal defect (VSD) formation etc.
Case:
Over Easter weekend, a 75-year-old male presented to our emergency room with an acute anterior myocardial infarction. Angiography revealed LAD obstruction, which was successfully stented. His EF then was 30% with anterior wall hypokinesia. Then, 7-months post-intervention, he presented again to us with severe shortness of breath and anasarca (NYHA IV). Clinically, he was in heart failure.