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CC BY-NC-ND 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences 2024; 16(03): 092-095
DOI: 10.1055/s-0044-1786685
Original Article

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

Yusuf Karancı
1   Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Türkiye
,
Cihan Bedel 
1   Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Türkiye
,
Fatih Selvi
1   Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Türkiye
,
Ökkeş Zortuk
1   Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Türkiye
› Institutsangaben Funding and Sponsorship None.
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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.

Keywords

acute coronary syndrome - echocardiography - electrocardiogram - focused cardiac ultrasound - regional wall motion abnormalities

Authors' Contributions

Y.K. and C.B.: Conceptualization, data curation, investigation, methodology, supervision, validation, visualization, writing – original draft, writing – review and editing. F.S. and O.Z.: Supervision, validation, visualization, writing – original draft, writing – review and editing.


Compliance with Ethical Principles

The study was approved by the Health Science University Antalya Training and Research Hospital Ethical Committee. Informed consent was obtained from the participants before data collection.




Publikationsverlauf

Artikel online veröffentlicht:
11. Juli 2024

© 2024. The Libyan Biotechnology Research Center. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Bhatt DL, Lopes RD, Harrington RA. Diagnosis and treatment of acute coronary syndromes: a review. JAMA 2022; 327 (07) 662-675
    CrossrefPubMedSuche in Google Scholar
  • 2 Eisen A, Giugliano RP, Braunwald E. Updates on acute coronary syndrome: a review. JAMA Cardiol 2016; 1 (06) 718-730
    CrossrefPubMedSuche in Google Scholar
  • 3 Arvig MD, Weile JB, Lindberg M, Wamberg J, Posth S. Focused cardiac ultrasound in emergency medicine. Ugeskr Laeger 2023; 185 (25) V02230130
    PubMedSuche in Google Scholar
  • 4 Rasooli F, Bagheri F, Sadatnaseri A, Ashraf H, Bahreini M. Comparison of emergency echocardiographic results between cardiologists and an emergency medicine resident in acute coronary syndrome. Arch Acad Emerg Med 2021; 9 (01) e53
    PubMedSuche in Google Scholar
  • 5 Via G, Hussain A, Wells M. et al; International Liaison Committee on Focused Cardiac UltraSound (ILC-FoCUS), International Conference on Focused Cardiac UltraSound (IC-FoCUS). International evidence-based recommendations for focused cardiac ultrasound. J Am Soc Echocardiogr 2014; 27 (07) 683.e1-683.e33
    CrossrefPubMedSuche in Google Scholar
  • 6 Bracey A, Massey L, Pellet AC. et al. FOCUS may detect wall motion abnormalities in patients with ACS. Am J Emerg Med 2023; 69: 17-22
    CrossrefPubMedSuche in Google Scholar
  • 7 Croft PE, Strout TD, Kring RM, Director L, Vasaiwala SC, Mackenzie DC. WAMAMI: emergency physicians can accurately identify wall motion abnormalities in acute myocardial infarction. Am J Emerg Med 2019; 37 (12) 2224-2228
    CrossrefPubMedSuche in Google Scholar
  • 8 Sağlam C, Ünlüer EE, Yamanoğlu NGÇ. et al. Accuracy of emergency physicians for detection of regional wall motion abnormalities in patients with chest pain without ST-elevation myocardial infarction. J Ultrasound Med 2021; 40 (07) 1335-1342
    CrossrefPubMedSuche in Google Scholar
  • 9 Sanjeevi G, Gopalakrishnan U, Pathinarupothi RK, Madathil T. Automatic diagnostic tool for detection of regional wall motion abnormality from echocardiogram. J Med Syst 2023; 47 (01) 13
    CrossrefPubMedSuche in Google Scholar
  • 10 Madathil T, Vanga SB, Jose RL, Pillai GG. Case report: a descending thoracic aortic aneurysm presenting as airway challenge. J Clin Anesth 2021; 71: 110230
    CrossrefPubMedSuche in Google Scholar
  • 11 Lin X, Yang F, Chen Y. et al. Echocardiography-based AI detection of regional wall motion abnormalities and quantification of cardiac function in myocardial infarction. Front Cardiovasc Med 2022; 9: 903660
    CrossrefPubMedSuche in Google Scholar
  • 12 Teira Calderón A, Levine M, Ruisánchez C. et al. Clinical comparison of a handheld cardiac ultrasound device for the assessment of left ventricular function. Int J Cardiovasc Imaging 2024; 40 (01) 55-64
    CrossrefPubMedSuche in Google Scholar
  • 13 Espersen C, Modin D, Platz E. et al. Global and regional wall motion abnormalities and incident heart failure in the general population. Int J Cardiol 2022; 357: 146-151
    CrossrefPubMedSuche in Google Scholar
  • 14 Jin W, Wang L, Zhu T, Ma Y, Yu C, Zhang F. Usefulness of echocardiographic myocardial work in evaluating the microvascular perfusion in STEMI patients after revascularization. BMC Cardiovasc Disord 2022; 22 (01) 218
    CrossrefPubMedSuche in Google Scholar