Cardiac imaging and assessment of left ventricular function

After suffering a myocardial infarction, all patients should have their LV function assessed prior to hospital discharge. Early assessment of LV function will aid in management, risk assessment, and prognosis. For patients undergoing coronary artery bypass grafting, LV function will be assessed preoperatively. For all patients suffering an intraoperative myocardial infarction, similar to any patient with a myocardial infarction, LV function should be assessed prior to hospital discharge to aid in formulating a treatment strategy, risk assessment, and prognosis. A lower EF will generally, but not absolutely, portend a poorer functional capacity (see earlier discussion). It would be desirable to repeat the assessment of LV performance in all patients except those with previously normal EF after the completion of a cardiac rehabilitation program (3 to 6 months after hospital discharge) to evaluate the response to therapy or earlier if indicated by the clinical scenario. In this article we have described several ways of measuring LV function. For each patient, the best modality to use will depend on the type of heart disease, if information other than global LV function is required, if LV function will need to be followed with sequential studies, and the modality present at each institution.