Echocardiographic diagnosis of left anterior descending coronary artery disease and left ventricular asynergy.

Interventricular septal (IVS) motion was studied by M-mode echocardiography in 60 patients to review the value of the technique in identifying left anterior descending (LAD) coronary artery disease. Abnormalities of IVS thickening and excursion were presented in 90% of patients with proximal LAD disease, whereas septal function was essentially normal in patients with distal LAD disease and in patients with disease of the right and/or circumflex coronary arteries. Abnormalities of IVS motion were greater in patients with a history of previous anterior wall infarction and/or the presence of angiographic left ventricular (LV) asynergy. There was no difference between patients with isolated or combined LAD disease, nor was there a difference between patients with complete or partial obstruction of the LAD, when more than 75% of the lumen was occluded. The echo was also useful in identification of anterior LV asynergy. Abnormal widening of the LV near the apex and abnormal septal movement in this area detected, with high sensitivity and specificity, patients with angiographic anterior wall asynergy.