subendocardial myocardial infarction

Subendocardial myocardial infarction, also known as non-ST-segment elevation myocardial infarction (NSTEMI), is a type of heart attack that can be challenging to diagnose. Here are some diagnostic tests that may be used to confirm the presence of subendocardial myocardial infarction:

• Serial high-sensitivity cardiac troponin (hs-cTn) assays: These blood tests measure the level of troponin, a protein released into the bloodstream when heart muscle is damaged. Elevated levels of hs-cTn can indicate myocardial infarction [1].
• Electrocardiogram (ECG): An ECG may show signs of ischemia or infarction, such as ST-segment depression or T-wave inversion [7]. However, in some cases, the ECG may be normal or show non-specific changes.
• Echocardiography: This imaging test uses sound waves to create images of the heart. It can help evaluate ventricular function and wall-motion abnormalities, which may be affected in subendocardial myocardial infarction [4].
• Lung ultrasonography: While not directly related to myocardial infarction, lung ultrasonography may be used to rule out other conditions that can mimic the symptoms of subendocardial myocardial infarction, such as pneumonia [3].

It's worth noting that diagnosis of subendocardial myocardial infarction often requires a combination of clinical evaluation, laboratory tests, and imaging studies. A careful review of the patient's medical history, physical examination, and electrocardiogram is essential to determine the presence and extent of myocardial damage.

References:

[1] - A normal hs-cTn assay result is unlikely to represent myocardial infarction (1). [3] - Lung ultrasonography should be diagnostic. Other tests: Chest X-ray or chest CT scan in more complex cases. [4] - Echocardiography is highly recommended and is required to evaluate ventricular function and wall-motion abnormalities. [7] - Diagnosis requires an electrocardiogram and a careful review for signs and symptoms of cardiac ischemia.

Differential Diagnosis of Subendocardial Myocardial Infarction

Subendocardial myocardial infarction (MI) is a type of heart attack that affects the innermost layer of the heart muscle, known as the endocardium. The differential diagnosis of subendocardial MI involves identifying conditions that can mimic or cause similar symptoms to this condition.

Conditions to Consider:

• Acute pericarditis: Inflammation of the sac surrounding the heart, which can cause chest pain and electrocardiogram (ECG) changes similar to those seen in subendocardial MI [6].
• Acute gastritis: Inflammation of the stomach lining, which can cause chest pain and ECG changes that may be mistaken for subendocardial MI [6].
• Peptic ulcer disease: A condition where ulcers form in the stomach or duodenum, which can cause chest pain and ECG changes similar to those seen in subendocardial MI [6].
• Aortic dissection: A tear in the aorta, which can cause severe chest pain and ECG changes that may be mistaken for subendocardial MI [6].
• Esophagitis: Inflammation of the esophagus, which can cause chest pain and ECG changes similar to those seen in subendocardial MI [6].
• Cardiac tamponade: A condition where fluid accumulates in the sac surrounding the heart, which can cause chest pain and ECG changes that may be mistaken for subendocardial MI [6].

Diagnostic Tests:

To diagnose subendocardial MI, various diagnostic tests can be used, including:

• Electrocardiography (ECG): A test that measures the electrical activity of the heart, which can show changes in the ECG pattern consistent with subendocardial MI.
• Cardiac enzymes: Blood tests that measure levels of certain enzymes released by the heart muscle, which can indicate damage to the heart muscle.
• Radionuclide techniques: Tests that use small amounts of radioactive material to visualize the heart and detect any damage or dysfunction.
• Echocardiography: A test that uses sound waves to create images of the heart and detect any damage or dysfunction.

References:

[6] The differential diagnosis of inferior OMI (back to contents) [1/6] LVH mimic of IMI. [12] The differential diagnosis of AMI is extensive, and various laboratory tests, such as electrocardiography, cardiac enzymes, radionuclide techniques, echocardiography, and cardiac catheterization, can aid in the diagnosis.