Abstract 1015: Frequency of Diastolic Third and Fourth Heart Sounds with Myocardial Ischemia during Percutaneous Coronary Intervention
Background: Although the standard 12-lead ECG is considered the gold standard to diagnose acute myocardial ischemia, nearly half of ECGs are non-diagnostic in patients who present with chest pain and have subsequent confirmation of infarction with positive serum biomarkers.
Methods: A prospective study was performed to investigate the frequency and intensity of diastolic third and fourth heart sounds (S3 and S4), as measured by non-invasive computerized acoustic cardiography, with myocardial ischemia induced by balloon occlusion during percutaneous coronary intervention (PCI).
Results: In our 24 subjects, during PCI-induced ischemia, a new or increased intensity S3 or S4 developed in 66.7% (Table 1⇓). Ten (66.7%) of 15 patients without clinical ST criteria for ischemia also developed new or increased intensity diastolic heart sounds
Conclusions: The combined use of diastolic heart sounds, as a measurement of ventricular dysfunction, with the standard ECG may improve the noninvasive diagnosis of myocardial ischemia that is likely to develop into infarction. (Table 2⇓).