Bubenheimer P
Ultraschall Med. 1983 Dec;4(4):213-20. doi: 10.1055/s-2007-1013068.
Coronary heart disease can be detected via echocardiography, if myocardial ischemia or infarction are present leading to segmental abnormalities of left ventricular function. The capability to demonstrate these regional changes is limited as far as TM echocardiography is concerned, whereas 2D echocardiography is more reliable. For this purpose, cross-sectional imaging of all segments in several planes is necessary. The complex mosaic of findings obtained in this way is best documented by means of a segmental scheme of representative sections. Infarct size then can be estimated by a segmental score. Depressed wall motion and systolic wall thickening are used as criteria for ischaemia and infarction. In the chronic phase, morphological changes can be identified additionally: Thinning, expansion and increased reflectivity of the infarcted areas. In acute myocardial infarction, echocardiography is mainly used if the course is complicated, in the chronic phase, if ECG-changes are questionable, or to evaluate residual ventricular function after large infarcts. Even the TM echocardiogram reliably estimates the ventricular damage caused by the infarct in the chronic phase.
如果存在心肌缺血或梗死导致左心室功能节段性异常，可通过超声心动图检测冠心病。就经胸超声心动图（TM 超声心动图）而言，显示这些区域变化的能力有限，而二维超声心动图更可靠。为此，需要在多个平面上对所有节段进行横断面成像。通过代表性节段的节段方案可以最好地记录以这种方式获得的复杂发现组合。然后可以通过节段评分来估计梗死面积。室壁运动减弱和收缩期室壁增厚用作缺血和梗死的标准。在慢性期，可以另外识别形态学变化：梗死区域变薄、扩张和反射率增加。在急性心肌梗死中，超声心动图主要用于病程复杂的情况，在慢性期用于心电图变化有疑问的情况，或用于评估大面积梗死后的残余心室功能。即使是 TM 超声心动图也能可靠地估计慢性期梗死对心室造成的损害。
