Question:
Intraoperative myocardial infarction is best diagnosed by:
Intraoperative myocardial infarction is best diagnosed by:
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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
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The Correct Option is D
Solution and Explanation
Step 1: Intraoperative myocardial ischaemia or infarction must be detected early and reliably under anaesthesia, where the patient cannot report chest pain.
Step 2: The earliest event in acute myocardial ischaemia is a regional wall motion abnormality, which appears before ECG changes and well before haemodynamic deterioration.
Step 3: Transoesophageal echocardiography (TEE) places the probe directly behind the heart and visualises regional wall motion in real time, making it the most sensitive intraoperative monitor for new ischaemia.
Step 4: ECG detects ischaemia later and may miss territories such as the posterior wall; invasive arterial pressure and central venous pressure are non-specific and change only after significant myocardial dysfunction.
Conclusion: The best intraoperative diagnostic tool is transoesophageal echocardiography, so option 4 is correct.
Step 2: The earliest event in acute myocardial ischaemia is a regional wall motion abnormality, which appears before ECG changes and well before haemodynamic deterioration.
Step 3: Transoesophageal echocardiography (TEE) places the probe directly behind the heart and visualises regional wall motion in real time, making it the most sensitive intraoperative monitor for new ischaemia.
Step 4: ECG detects ischaemia later and may miss territories such as the posterior wall; invasive arterial pressure and central venous pressure are non-specific and change only after significant myocardial dysfunction.
Conclusion: The best intraoperative diagnostic tool is transoesophageal echocardiography, so option 4 is correct.
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