10 – Myocardial infarction

This chapter discusses the recent progress in echocardiography, nuclear imaging techniques, CMR, and CT in characterizing patients with acute myocardial infarct. It will expose the pathophysiology of acute infarcts and the principles by which non-invasive imaging techniques allow the identification of different characteristics of infarcted myocardium such as necrosis, area at risk, microvascular obstruction, edema, hemorrhage, and altered metabolism and innervation. Next, it will discuss the clinical role of the different imaging techniques in patients with infarct and, in particular, for diagnosis of acute infarct, detection of acute and chronic complications, post-infarct remodeling, prediction of prognosis, identification of high risk patients, and selection of device and revascularization therapy. Finally, we attempt to provide an outlook on new and upcoming developments in infarct imaging for each of the respective imaging techniques.