The surgical complications of acute myocardial infarction: color Doppler evaluation.

Two-dimensional echocardiography in combination with Doppler and color Doppler flow mapping is now considered the technique of choice for the early diagnosis and assessment of the 'surgical' complications of acute myocardial infarction. It has the advantage of being a rapid, safe technique with ease of portability and repeatability, at relatively low cost. Transesophageal echocardiography may provide an alternative 'window' for imaging cardiac structure and function, but as yet its value in the diagnosis of the complications of myocardial function is not proven. In the acute phase, color Doppler flow mapping can diagnose the cause of hemodynamic deterioration by distinguishing primary pump failure from the mechanical complications such as ventricular septal rupture or papillary muscle rupture. In the subacute phase, complications including left ventricular true and false aneurysms may be detected and this information allows optimal management decisions to be made. Thus, color Doppler flow mapping has become an indispensable technique in the coronary care unit. It provides a complete picture of cardiac structure and function making it superior to other methods in the clinical situation of an acute myocardial infarction which has such a volatile and unpredictable course.