Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

27 April 2019 : Case report  USA

A Case of Myocardial Ischemia Detected by Global Longitudinal Strain Using Intraoperative Speckle-Tracking Echocardiography in a High-Risk Patient Undergoing Abdominal Aortic Aneurysm Repair

Challenging differential diagnosis, Management of emergency care

Seth Eisenberg1ABCDEF, Theodore J. Cios1CDEF, S. Michael Roberts1ABCDEF*

DOI: 10.12659/AJCR.914858

Am J Case Rep 2019; 20:607-611

Abstract

BACKGROUND: Global longitudinal strain (GLS) detected by echocardiography has been shown to have a prognostic role in the evaluation of myocardial ischemia in several clinical settings. A case is presented where GLS was used to detect intraoperative myocardial ischemia in a high-risk patient undergoing open abdominal aortic aneurysm repair.

CASE REPORT: A 75-year-old Caucasian man with non-insulin dependent diabetes mellitus and a 60 pack-year smoking history presented with a one-week history of exertional chest pain. Two-dimensional (2D) speckle-tracking echocardiography was used to calculate myocardial velocities and deformation parameters, including GLS. A reduced baseline GLS of –18.2% was found with dysfunction of the basal anterior, inferior, and mid anterolateral wall of the left ventricle. During aortic cross-clamping, his basal segments became mildly hypokinetic, although his ejection fraction (EF) remained unchanged at 50–55%. Despite normal left ventricular systolic function on visual assessment, his GLS decreased to –14.2% during aortic cross-clamping with similar segmental changes noted in the baseline GLS analysis. After the release of the aortic cross-clamp, his basal segments returned to normal and his left ventricular systolic function improved with an EF of 60–65% and the GLS recovered to -18.4% with improvement in the basal segmental function.

CONCLUSIONS: This case report showed that detection of GLS by echocardiography was a sensitive indicator of myocardial dysfunction that was superior to regional ventricular wall assessment. Detection of early changes in myocardial function by evaluating GLS may assist in guiding anesthetic management in high-risk patients with ischemic heart disease.

Keywords: aortic aneurysm, Echocardiography, Myocardial Ischemia, Aged, cardiac catheterization, Heart Ventricles, Vascular Surgical Procedures, Ventricular Function, Left

0 Comments

In Press

27 Jan 2023 : Case report  Spain

A 37-Year-Old Man with Familial Hereditary Hemorrhagic Telangiectasia and Pulmonary Arteriovenous Malformat...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938548  

26 Jan 2023 : Case report  Spain

A 39-Year-Old Woman with Endometriosis Who Developed a Subcapsular Liver Hematoma Following Laparotomic Sur...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938169  

26 Jan 2023 : Case report  USA

Optic Neuritis as a Consequence of Long-Term Medical Treatment Using Anastrozole: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.939026  

26 Jan 2023 : Case report  USA

A Rare Case of Ruptured Appendicitis Secondary to Metastatic Ovarian Cancer

Am J Case Rep In Press; DOI: 10.12659/AJCR.938982  

Most Viewed Current Articles

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

17 Feb 2022 : Case report  Oman

Myocarditis, Pulmonary Hemorrhage, and Extensive Myositis with Rhabdomyolysis 12 Days After First Dose of P...

DOI :10.12659/AJCR.934399

Am J Case Rep 2022; 23:e934399

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923