Discussion
Currently, Cardiology societies recommend the use of UEA when
>2 contiguous LV segments are not visible on non-contrast
images [9]. Herein, we demonstrate a
case where routine beside echocardiography was limited by poor
visualization of the LV endocardial borders highlighting the critical
impact UEA may have on clinical decision making.
In our patient, the initial treatment plan was for emergent percutaneous
coronary revascularization and temporary left ventricular assist device
placement. However, the use of UEA with a focused study completely
transformed patient management. UEA allowed us to identify a large LV
pseudoaneurysm which would have rendered any such interventions
potentially catastrophic. Instead, we consulted cardiothoracic surgery
emergently to evaluate for open heart surgical revascularization and
repair of the LV pseudoaneurysm. The use of echocardiography with UEA in
this patient was potentially life-saving and prevented a potentially
disastrous iatrogenic complication.