will an echo cardiogram rule out miocardial ischimia?

Answer 1

No but what will show ischemia would be a nuclear stress test.

Answer 2

Smart Alec covered this subject mostly. As he mentioned an echo-cardiogram may demonstrate evidence of myocardial ischemia by changes in the wall motion of the heart. An enzyme blood test will demonstrate only infarction (irreversible damage) rather than an earlier state of ischemia. The amount of enzyme elevation is not a good indicator of the severity of the infarct. Impaired kidney function can artificially contribute to elevate these enzymes to a moderate degree.

Stress echo-cardiograms are very useful in helping to rule out ischemia. A stress echo combines exercise which induces stress on the heart with real time imaging. If ischemia is occurring the motion of the heart wall will change in comparison to how it was moving during rest. If an infarct occurred then the wall motion of the heart will be impaired at rest rather than impaired only with exercise.

The study has roughly a 90% rate of being able to demonstrate ischemia if it is truly there. You would use this study most likely in a patient who has an intermediate chance of having true disease. If you have a high chance of disease, it is probably in your best interest to have an angiogram. Because with the right risk factors and symptoms, even if you had a negative stress echo-cardiogram, then you would proceed to an angiogram anyway to be certain. If you have a low chance of disease, it probably is unnecessary to do any study at all.

Answer 3

Many interesting answers here - all very thoughtful of course, but nevertheless, incomplete. Myocardial ischemia is a complex phenomenon that seems to perplex the best of scientific minds out there. However, diagnosing it has definitely become more easier and simpler with the improvement in technology.
Generally, the diagnosis of myocardial ischemia (which is nothing but the state of the blood-deprived heart) starts with a sound clinical judgement. When there is enough grounds for clinical suspicion, help is usually sought from the EKG (which may or may not show any change or changes that are suggestive), and certain blood tests (specifically testing for evidence of spillage of certain enzymes from heart muscle that has been damaged by the lack of blood supply). An echocardiogram can be particularly useful in those cases where even the blood tests described above are inconclusive, and also in those cases where further information regarding prognosis in a particular patient would be necessary.
An echocardiogram is expected to give information on the state of functioning of the heart, show any evidence of abnormal motion of all or a part of the heart that may be a telltale evidence of myocardial ischemia, etc.

Answer 4

an echo will not be able to tell you anything about ischemia (which is inadequate blood flow to heart tissue that is REVERSIBLE). At best, it will tell you if any areas have been infarcted (IRREVERSIBLE damage to heart tissue). And if it's a small area, echo won't even pick it up! There are better tests out there to determine ischemia, including an EKG (ST depressions) and the patient's chest pain itself that can correlate with it. Stress test with nuclear imaging or stress echo would be better determinants of ischemia and can actually pin-point which areas, and therefore, cardiac blood vessels that may be affected and guide further management (heart cath, bypass, etc)

Answer 5

Echo's are used to assess valve function and wall motion of the heart. They are primarily used to assess possible damage from a heart attack (ie: wall motion defects/ventricular function/valve prolapse-gradients). EKG's will show the current electrical activity of the heart-if there is ischemia present -ST ELEVATIONS maybe seen (ST depression indicates myocardial damage vs ischemia). Cardiac assay (serum studies) are done to detect levels that can help determine if a person has suffered heart injury. When ischemia is suspected, a common test is a stress test. If abnormalities are detected during this test, cardiologists will recommend coronary angiography to assess for occlusions and possible interventions(ie: PTCA/stents/possible CABG) .

Answer 6

No, not definitively. A blood test, specifically a cardiac enzyme test, will determine if an MI occurred. They are always done if an MI is suspect. Other tests will be done to determine the severity & amount of damage that has been done, & whether or not the damage is permanent.

Answer 7

It won't always rule it out, although in most cases if the ischemia is becoming severe the EKG will show what is refered to as S-T DEPRESSION.

Answer 8

it can show several things but may not show ischemia. you have to have an angiogram to determine definately.

Answer 9

http://www.lungcancerfrontiers.org/books/pul_pro/ultrasound.html

Answer 10

No.