Regional Wall Motion Abnormalities (RWMA) in Echocardiography

Regional wall motion abnormalities (RWMA) are often the earliest echocardiographic clue that something is wrong—sometimes appearing before EKG changes or lab results. Missing them can delay diagnosis; recognizing them can directly influence downstream clinical decisions.

This lesson focuses on how experienced echocardiography professionals evaluate left ventricular wall motion patterns to identify subtle abnormalities, avoid common pitfalls, and distinguish ischemic from non-ischemic causes. While echocardiography cannot visualize the coronary arteries themselves, wall motion abnormalities reflect the mechanical consequences of ischemia or myocardial injury—making pattern recognition essential.

You’ll learn how to:

• Understand what wall motion truly represents (motion vs thickening)

• Apply the ASE 17-segment model for accurate, standardized reporting

• Correlate wall motion patterns with coronary artery territories

• Differentiate ischemic patterns from non-ischemic causes such as cardiomyopathy, conduction disease, or Takotsubo cardiomyopathy

• Improve confidence through systematic acquisition, multi-view confirmation, and pattern-based interpretation

Developing a strong eye for regional wall motion abnormalities is one of the skills that separates robotic image acquisition from the art of echocardiography.