LA Strain in Predicting Early Complication in STEMI After PPCI

Inclusion Criteria: * Adults aged ≥18 years. * Diagnosed with ST-segment elevation myocardial infarction (STEMI) according to current ESC/AHA criteria * Underwent successful primary percutaneous coronary intervention (PPCI) within 12 hours of symptom onset. * Sinus rhythm on admission . * Trans thoracic echocardiography (TTE) performed within 48 hours of admission with adequate image quality for speckle-tracking analysis. Exclusion Criteria: * Previous myocardial infarction or prior PCI/CABG. * Patients known to have atrial fibrillation or other sustained supraventricular arrhythmias. * Significant valvular heart disease (severe stenosis or regurgitation). * Congenital heart disease or cardiomyopathy (hypertrophic, dilated, restrictive). * Poor echocardiographic window preventing LA strain analysis . * Mechanical complications (e.g., papillary muscle rupture, VSD, free wall rupture). * Prior cardiac surgery or known structural lesions that preventing reliable LA measurement. * patient presenting with killip class III or IV from the start