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.