Evaluation of Regional Wall Motion Abnormalities with Echocardiography in the Emergency Department

Abstract

Introduction Acute coronary syndrome (ACS) is a major cardiovascular disease, particularly in cases where standard electrocardiogram findings are equivocal. Focused cardiac ultrasound (FOCUS) has become increasingly accepted as a tool in emergency medicine. The primary objective of this study was to evaluate the accuracy, sensitivity, and specificity of FOCUS in detecting regional wall motion abnormalities (RWMA) compared with standard echocardiography (ECHO). Materials and Methods This prospective observational study included 91 patients who presented to the emergency department between June 1, 2023, and November 30, 2023. Senior emergency physicians performed FOCUS examinations, which were performed by an emergency assistant or specialist who works in the emergency department, has at least 2 years of experience in ultrasonography (USG), and has basic USG and advanced USG certificates. The examinations assessed the presence of RWMA in each patient's left ventricle. Results All 91 patients were included in the study for comparison with formal ECHO. The mean age was 58, and 32% of patients were female. Compared with the criterion standard of formal ECHO, the sensitivity of FOCUS performed by emergency physicians for detecting RWMA was 85% (95% confidence interval [CI], 73–92), the specificity was 53% (95% CI, 36–69), and the overall accuracy was 74% (95% CI, 64–82). Conclusion Our study demonstrates the potential utility of FOCUS performed by emergency physicians in detecting RWMA in patients with high suspicion of ACS.