Question:medium
Intraoperative myocardial infarction is best diagnosed by:
Intraoperative myocardial infarction is best diagnosed by:
Show Hint
What detects a regional wall motion abnormality before the ECG does?
Updated On: Jun 24, 2026
- ECG
- Invasive arterial pressure
- Central venous pressure
- Transoesophageal echocardiography
Show Solution
The Correct Option is D
Solution and Explanation
During surgery a patient under anaesthesia cannot complain of angina, so the anaesthetist must rely on monitors to catch a developing heart attack. The question asks which monitor gives the most reliable and earliest warning.
The key physiological fact is the ischaemic cascade: when a region of myocardium loses its blood supply it stops contracting normally almost immediately. This regional wall motion abnormality precedes ST-segment shifts on the ECG and precedes any fall in blood pressure. A tool that images wall motion will therefore alarm first.
Transoesophageal echocardiography sits the ultrasound probe in the oesophagus just behind the left atrium, giving a clear continuous view of how each segment of the ventricle moves. This makes it the most sensitive intraoperative detector of new ischaemia. The ECG lags behind and can miss the posterior wall, while invasive arterial and central venous pressures only change once pump function has already failed. Hence TEE is the best answer.
\[\boxed{\text{Transoesophageal echocardiography}}\]
The key physiological fact is the ischaemic cascade: when a region of myocardium loses its blood supply it stops contracting normally almost immediately. This regional wall motion abnormality precedes ST-segment shifts on the ECG and precedes any fall in blood pressure. A tool that images wall motion will therefore alarm first.
Transoesophageal echocardiography sits the ultrasound probe in the oesophagus just behind the left atrium, giving a clear continuous view of how each segment of the ventricle moves. This makes it the most sensitive intraoperative detector of new ischaemia. The ECG lags behind and can miss the posterior wall, while invasive arterial and central venous pressures only change once pump function has already failed. Hence TEE is the best answer.
\[\boxed{\text{Transoesophageal echocardiography}}\]
Was this answer helpful?
0
