What regional wall-motion pattern would indicate an acute coronary syndrome on echocardiography?

What regional wall-motion pattern would indicate an acute coronary syndrome on echocardiography?

• A. Global hyperkinesis.
• B. New regional wall-motion abnormality in a coronary territory.
• C. Uniform akinesis of all walls.
• D. Normal wall motion with preserved EF.

Answer: (C)

The key idea is that acute coronary syndrome shows up on echocardiography as a new regional wall-motion abnormality in the coronary artery’s territory. When a coronary artery acutely occludes, the myocardium it feeds becomes ischemic and fails to move normally in that specific region, leading to hypokinesis (reduced movement), akinesis (no movement), or even dyskinesis (paradoxical motion) in that localized area. This focal change, rather than a uniform pattern across the whole ventricle, is what points to an acute process. If the entire heart were akinetic, that would suggest global myocardial dysfunction such as severe diffuse ischemia or cardiogenic shock, not a localized ACS event. Global hyperkinesis isn’t characteristic of ACS either, and normal wall motion with preserved ejection fraction would not indicate an acute ischemic event.

The key idea is that acute coronary syndrome shows up on echocardiography as a new regional wall-motion abnormality in the coronary artery’s territory. When a coronary artery acutely occludes, the myocardium it feeds becomes ischemic and fails to move normally in that specific region, leading to hypokinesis (reduced movement), akinesis (no movement), or even dyskinesis (paradoxical motion) in that localized area. This focal change, rather than a uniform pattern across the whole ventricle, is what points to an acute process.

If the entire heart were akinetic, that would suggest global myocardial dysfunction such as severe diffuse ischemia or cardiogenic shock, not a localized ACS event. Global hyperkinesis isn’t characteristic of ACS either, and normal wall motion with preserved ejection fraction would not indicate an acute ischemic event.