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Ischaemic heart disease 

Ischaemic heart disease
Chapter:
Ischaemic heart disease
Author(s):

Petros Nihoyannopoulos

and Fausto Pinto

DOI:
10.1093/med/9780199599639.003.0012
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date: 22 August 2019

Echocardiography with its multiple modalities plays a central role in the evaluation of patients with known or suspected coronary artery disease, starting from the differential diagnosis of the patient presenting with acute chest pain. In the patient presenting with acute myocardial infarction (raised troponins) whether it is with ST-segment elevation or without, echocardiography is the first imaging modality used in order to ascertain the presence and extent of LV dysfunction and the presence of complications. In the absence of myocardial infarction (negative troponins), echocardiography will play an important diagnostic role in identifying the presence of reversible myocardial ischaemia. Stress echocardiography in many institutions is now the preferred stress modality associated with imaging as it is cost-effective and does not use ionizing radiation. Finally, echocardiography plays a pivotal role in the assessment of myocardial viability since the presence and extent of viable myocardium may guide therapeutic strategies. It has been stressed that laboratories and individuals need to have experience and be accredited by the authorities so that the results of echocardiographic investigations will be credible.

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