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Chest, Vol 73, 382-386, Copyright © 1978 by American College of Chest Physicians

ARTICLES

Delayed peak of the posterior wall. A new echocardiographic index of posterior wall aneurysm

S Ogawa, FJ Pauletto, AN Moghadam, RA Akhtar and LL Meixell

Delayed posterior wall (PW) peak in the detection of PW asynergy was studied by M-mode echocardiography in 53 patients with angiographically proven PW aneurysm, hypokinesis and normal PW. The timing of the PW peak was evaluated by the intervals between (1) the aortic valve closure (Ac) and the PW peak, and (2) the R wave of the electrocardiogram and the PW peak (R-peak). The PW excursion predicted only 39 percent with aneurysm and none with hypokinesis. In contrast, 13 of 18 patients with aneurysm and 4 of 13 patients with hypokinesis demonstrated significantly delayed PW peaks occurring between 0.05 and 0.1 sec following Ac (normal 0 to 0.05 sec). A new index, a ratio of R- peak to ejection time (R-peak/ET) of 1.35 or greater was found to be highly indicative of PW aneurysm in 16 of 18 patients.




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Copyright © 1978 by the American College of Chest Physicians.