Acute Anterior MI

 

Image Library Home >>Ischemic Heart Disease>> Acute Anterior MI

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This individual had an acute proximal LAD occlusion. This first image in the parasternal long axis shows a markedly hypokinetic to akinetic anteroseptum without thinning suggesting an acute or subacute event.

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Two parasternal short axis views at the base (left panel) and mid LV (right panel) show clear regional wall motion abnormalities with the anterior wall and anteroseptum akinetic. The inferior wall and lateral wall are contracting at these levels.

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The apical windows show the true extent of acute injury. The anterior wall to the apex is akinetic (4 chamber view, upper left), the anterolateral wall akinetic from midwall to apex (5 chamber view, upper right) and the inferior wall (2 chamber view, lower left ), inferoseptum (4 chamber view, upper left and inferolateral wall (apical long axis view, lower right) are also involved. This was a large LAD that wrapped around the apex and also supplied the distal inferior wall.

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A final close-up view of the LV in the 4 chamber shows the mid wall to apex area of hypokinesis with sparing of the base. Under other circumstances this might be consistent with a Takotsubo type of cardiomyopathy which should also be in the differential of the echocardiography reader.