Echocardiography in the Recognition and Management of Mechanical Complications of Acute Myocardial Infarction

Curr Cardiol Rep. 2024 May;26(5):393-404. doi: 10.1007/s11886-024-02042-5. Epub 2024 Mar 25.

Abstract

Purpose of review: Although rare, the development of mechanical complications following an acute myocardial infarction is associated with a high morbidity and mortality. Here, we review the clinical features, diagnostic strategy, and treatment options for each of the mechanical complications, with a focus on the role of echocardiography.

Recent findings: The growth of percutaneous structural interventions worldwide has given rise to new non-surgical options for management of mechanical complications. As such, select patients may benefit from a novel use of these established treatment methods. A thorough understanding of the two-dimensional, three-dimensional, color Doppler, and spectral Doppler findings for each mechanical complication is essential in recognizing major causes of hemodynamic decompensation after an acute myocardial infarction. Thereafter, echocardiography can aid in the selection and maintenance of mechanical circulatory support and potentially facilitate the use of a percutaneous intervention.

Keywords: Cardiogenic shock; Free wall rupture; Mechanical complications; Papillary muscle rupture; Pseudoaneurysm; Ventricular septal rupture.

Publication types

  • Review

MeSH terms

  • Echocardiography / methods
  • Echocardiography, Doppler, Color
  • Heart-Assist Devices / adverse effects
  • Humans
  • Myocardial Infarction* / complications
  • Myocardial Infarction* / diagnostic imaging
  • Myocardial Infarction* / therapy
  • Percutaneous Coronary Intervention