Association between latest activated sites in the left ventricle and akinetic segments in patients with ischemic cardiomyopathy

Background: It is not clear whether the latest activation sites in the left ventricle [LV] are matched with infracted regions in patients with ischemic cardiomyopathy [ICM]. We aimed to investigate whether the latest activation sites in the LV are in agreement with the region of akinesia in patients with ICM

Methods: Data were analyzed in 106 patients [age = 60.5 +/- 12.1 y, male = 88.7%] with ICM [ejection fraction 120 ms

Results: A total of 1 272 segments were studied. The latest activation sites [with longest Ts] were most frequently located in the mid-anterior [n = 32, 30.2%] and basal-anterior segments [n = 29, 27.4%], while the most common sites of akinesia were the mid-anteroseptal [n = 65, 61.3%] and mid-septal [n = 51, 48.1%] segments. Generally, no significant concordance was found between the latest activated segments and akinesia either in all the patients or in the QRS groups. Detailed analysis within the segments indicated a good agreement between akinesia and delayed activation in the basal-lateral segment solely in the patients with QRS duration

Conclusion: The akinetic segment on 2-dimensional echocardiogram was not matched with the latest activation sites in the LV determined by TDI in patients with ICM

Quadricuspid aortic valve diagnosed by transesophageal echocardiography: a case report

Quadricuspid aortic valve [QAV] is an uncommon congenital anomaly which was an incidental finding during surgery or autopsy in the past. We present the case of a 44-year-old woman with moderately severe aortic regurgitation due to unequal cusp size QAV diagnosed via transesophageal echocardiography. Due to echocardiographic imaging improvement, the diagnosis of QAV is now easier and earlier than the past

Free wall rupture and ventricular septal defect post acute anterior myocardial infarction

Myocardial free wall rupture is a catastrophic complication of acute myocardial infarction, and prognosis will depend on the prompt diagnosis by echocardiography, extension of infarct size, and prompt surgical treatment. Free wall rupture concomitant with ventricular septal defect [VSD] may be more complicated for management. A case of a 69-year-old man with myocardial free wall rupture and VSD following acute anterior myocardial infarction is presented