[Comparison of the diagnostic value of echocardiographic, ecg and enzymatic investigations in acute myocardial infarction].

Two dimensional echocardiography (ECHO 2D) was performed in 133 patients 1-2, 3-5, 7-10, 21-28 days and 3, 6, 9, 12, 18 and 24 months after myocardial infarction. Standard ecg examination was carried out at the admission time, every 15 minutes during the first 2 hours, 3, 6, 12, 24 and 48 hours later, and afterwards in the same time as ECHO 2D. At the admission time and 4, 8, 12, 16, 20, 24, 36, 48, 60, and 72 hours later creatine kinase activity was determined. It is concluded that a relation exists between severity and extensiveness of myocardial infarction in ecg and severity and the asynergy area in the ECHO 2D study. In transmural anterior infarction large concordance exists in necrosis location estimated by both methods. In the inferior myocardial infarction asynergy concerns inferior, posterior and lateral LV wall and RV walls. V5-6 ecg leads appear of little value in infarct location. The lack of infarct evolution in ecg coexists with exacerbation of LV asynergy and extension of the LV asynergy area. Sensitivity of ECHO 2D in detecting myocardial infarction in the first day was 90%, ecg - 83%, enzymatic examination - 98%. 2 or 3 methods all together have high sensitivity (99%-100%).