The most sensitive and practical technique for detection of myocardial ischemia in the perioperative period is - (AIIMS Nov 11)
|A||Magnetic Resonance Spectroscopy|
|B||Radio labeled lactate determination|
|C||Direct measurement of end diastolic pressure|
|D||Regional wall motion abnormality detected with the help of 2D transoesophageal echocardiography|
Regional wall motion abnormality detected with the help of 2D transoesophagealechocardiography
[Ref: Morgan's Anaesthesia 3rd/e p. 403, 404, 402]
Two dimensional transesophageal echocardiography is the most sensitive method to detect myocardial ischemia in the preoperative period.
But there are doubts, if its a practical procedure too.
"Detection of regional wall motion abnormality is a rapid and more sensitive indicator of myocardial ischemia than is the E.C.G but unfortunately TEE requires expensive equipment and considerable familiarity with the technique in order to make correct and rapid interpretations intraoperatively".