Echocardiography-in ACUTE CORONARY SYNDROME
Stress echocardiography has been shown to be a modality equivalent to stress SPECT MPI in the acute setting in low-to-intermediate risk patients, with a stress pharmacologic agent (such as dobutamine) inducing focal wall- motion abnormalities in the region(s) of ischemia .
Overall left ventricular function can also be assessed. The presence of left ventricular aneurysms, pseudo aneurysms, effusions, and valvular dysfunction can be determined as well.
The primary utility of transesophageal echocardiography (TEE) in the setting of acute chest pain is in ruling out aortic dissection in unstable patients.
TEE is also used to further define valvular dysfunction or intracardiac thrombus, which can be sequelae of ischemic events in the subacute setting.
Because of the semi-invasive nature of TEE and because there is limited information that can be added in the setting of acute chest pain, this modality is generally not indicated in the workup of patients with acute chest pain