WAMAMI: emergency physicians can accurately identify wall motion abnormalities in acute myocardial infarction.

Document Type

Article

Publication Date

12-1-2019

Institution/Department

Emergency Medicine; Cardiology

Journal Title

The American journal of emergency medicine

MeSH Headings

Adult, Aged, Aged, 80 and over, Chest Pain, Echocardiography, Emergency Medicine, Emergency Service, Hospital, Female, Humans, Internship and Residency, Male, Middle Aged, Point-of-Care Testing, Predictive Value of Tests, Prospective Studies, ST Elevation Myocardial Infarction, Single-Blind Method

Abstract

OBJECTIVE: The ability to identify wall motion abnormalities may be useful for emergency clinicians, but is not typically evaluated in point-of-care echocardiograms. We sought to determine if emergency physicians with basic training in emergency echocardiography could identify regional wall motion abnormalities (RWMA) in patients admitted with ST-elevation myocardial infarction (STEMI).

METHODS: We prospectively enrolled patients with admitted with STEMI. Resident physicians with basic training in emergency ultrasound, blinded to other patient data, performed a point-of-care echocardiogram to evaluate for RWMA. If present, they also recorded the suspected territory of the RWMA. We calculated test performance characteristics and compared the agreement between point-of-care and comprehensive echocardiogram for RWMA and territory.

RESULTS: 75 patients with STEMI were enrolled, and 62% had a RMWA. RWMA were identified with excellent test performance characteristics (sensitivity 88% (95% CI 75-96); specificity 92% (95% CI 75-99)). There was substantial agreement between the point-of-care echocardiogram and reference standard (K = 0.79; 95% CI: 0.64-0.94).

CONCLUSIONS: Emergency physicians with core training in point-of-care echocardiography can accurately identify RMWA.

ISSN

1532-8171

First Page

2224

Last Page

2228

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