This echocardiogram shows the left ventricular septum and the posterior left ventricular wall. The left ventricle, right ventricle, aorta and left atrium are also well seen. Note that the ventricular septum has begun to thin. In the real-time study that follows, note the markedly reduced motion of the ventricular septum, characteristic of severe ischemia or infarction, compared to the normal systolic thickening and motion of the posterior left ventricular wall. The anatomy and function of the mitral and aortic leaflets are normal. There is no evidence of a ventricular septal defect or pericardial effusion.
Apex & Ant. Wall hypokinesis
This apical 2-chamber view shows the anterior wall, apex and posterior wall of the left ventricle. The left atrium and mitral valve are also seen. Note that in this view, the ventricular septum is not seen. In the real-time study that follows, note the reduced motion of the left ventricular apex and anterior wall, as compared to the posterior wall.
Our patient's study results
Our patient's echo-Doppler study performed in the emergency room revealed a large area of anteroseptal hypokinesis. The estimated global left ventricular ejection fraction was thiry to thirty-five percent, normal being fifty-five to seventy percent. There was no pericardial effusion and the Doppler study showed no evidence of mitral regurgitation or a ventricular septal defect.
Echoes that follow
The 2-dimensional echocardiograms that follow are from other patients with complications of acute myocardial infarction.
TEE - ruptured papillary muscle
This is a still-frame close-up of a 4-chamber transesophageal echocardiogram in the transverse plane from a patient with a ruptured papillary muscle following an acute myocardial infarction. It clearly shows the flail posterior leaflet of the mitral valve with a piece of the ruptured papillary muscle still attached to it. The left atrium and left ventricle are also well seen. In the real-time study that follows, note the flail motion of the posterior leaflet of the mitral valve.
4-chamber view - ventricular thrombus
This is a 4-chamber view from a patient with a left ventricular thrombus. The freshness of the thrombus is evidenced by its echoluscent center and the mobility of its surface. It is adherent to the left ventricular septum and apex. The left ventricle, mitral valve and left atrium are also labeled. The real-time study follows.