الفهرس 
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Abstract
Introduction: Acute coronary syndromes (ACS) are clinical events that cause immediate morbidity and mortality and a high risk of a further coronary accident at intervals a year. Aim of the work: The study aims to assess left ventricle systolic function using conventional Echocardiography in comparison with speckle tracking Echocardiography in STEMI patients. Methods: This comparative cross sectional study that was conducted in order to assess left ventricular ejection fraction by conventional echocardiography compared to longitudinal strain in STEMI patients. It had been done on 87subjects in the Cardiology Department of Specialized Medical Hospital, Faculty of Medicine; Mansoura University; during the period from July 2018 to July 2019. All patients included in the study were subjected to medical history (presenting complaint, chest pain analysis, and presence of dyspnea), clinical examination (BP measurement, presence and degree of lower lime edema and cardiac auscultation), Electrocardiography, and Echocardiography using conventional echocardiography, TDI and speckle echocardiography Data were analyzed with SPSS version 21. Results: We found the following: • In Anterior STEMI group significant statistical difference (p=0.001) between 2D-ECHO and Speckle, with a mean of 37.78 ± 4.7 in 2D-ECHO &27.42±9.2 in speckle. • In inferior STEMI group significant statistical difference (p=0.03) between 2D-ECHO and Speckle. The mean of 2D- ECHO is 57.05±6.27, while the Speckle mean is 39.30±12.60. • In lateral STEMI group significant statistical difference (p=0.11) between 2D-ECHO and speckle, with a mean of 59.33 ± 8.10in 2D-ECHO and 39.68 ± 9.21 in speckle Conclusion Myocardial strain is a good prognostic tool for giving additional information about descision making with conventional echocardiography .However it may have some problems as complexity, diversity of strain measurements and a lack of normal reference values can be solved with technical improvements and clinical studies.