Value of regional wall motion abnormality in the emergency room diagnosis of acute myocardial infarction

A prospective study using two-dimensional echocardiography

Peter Sabia, Ali Afrookteh, Dale A. Touchstone, Mark W. Keller, Lidiette Esquivel, Sanjiv Kaul

Research output: Contribution to journalArticle

186 Citations (Scopus)

Abstract

Because regional wall motion abnormality (RWMA) is usually noted during ischemia, we hypothesized that the presence of this finding with two-dimensional echocardiography would be superior to conventional methods of diagnosing acute myocardial infarction (AMI) in the ~ emergency room. We also hypothesized that because the absence of RWMA would probably not be associated with AMI, the use of two-dimensional echocardiography would significantly limit unnecessary hospital admissions. To test these hypotheses, we undertook a prospective study that used two-dimensional echocardiography in 180 patients presenting to the emergency room with symptoms suggestive of AMI. The emergency room physicians were not informed of the two-dimensional echocardiography findings, and their decision to admit or not admit to the hospital was based on conventional clinical and electrocardiographic criteria. Forty patients were not admitted to the hospital and 140 were admitted. Of the 30 patients with enzyme-confirmed AMI, nine had typical ST elevation on the ECG that was consistent with acute injury, three had normal ECGs, and eight had ECGs in the presence of which AMI could not have been diagnosed (left bundle branch block, paced rhythm, or repolarization changes); the rest had nonspecific ECG findings. Of the 29 AMI patients with technically adequate two-dimensional echocardiography studies, two did not demonstrate RWMA and 27 had RWMA, compared with nine with diagnostic ECG changes (p

Original languageEnglish (US)
JournalCirculation
Volume84
Issue number3 SUPPL.
StatePublished - Sep 1991
Externally publishedYes

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Echocardiography
Hospital Emergency Service
Myocardial Infarction
Prospective Studies
Electrocardiography
Bundle-Branch Block
Ischemia
Physicians
Wounds and Injuries
Enzymes

Keywords

  • Acute myocardial infarction
  • Two-dimensional echocardiography

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Value of regional wall motion abnormality in the emergency room diagnosis of acute myocardial infarction : A prospective study using two-dimensional echocardiography. / Sabia, Peter; Afrookteh, Ali; Touchstone, Dale A.; Keller, Mark W.; Esquivel, Lidiette; Kaul, Sanjiv.

In: Circulation, Vol. 84, No. 3 SUPPL., 09.1991.

Research output: Contribution to journalArticle

Sabia, Peter ; Afrookteh, Ali ; Touchstone, Dale A. ; Keller, Mark W. ; Esquivel, Lidiette ; Kaul, Sanjiv. / Value of regional wall motion abnormality in the emergency room diagnosis of acute myocardial infarction : A prospective study using two-dimensional echocardiography. In: Circulation. 1991 ; Vol. 84, No. 3 SUPPL.
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