Regional wall motion abnormality on an echocardiogram
Regional wall motion abnormality on an echocardiogram means that a region of the heart muscle is not contracting as it normally should. Short form often used is RWMA. It could be a decrease in the amplitude of contraction known as hypokinesia, absence of contraction known as akinesia or paradoxical bulging out when the rest of the heart muscle contracts, known as dyskinesia. Regional wall motion abnormalitiy suggests abnormality in the blood flow to the corresponding region of the heart muscle (myocardium). Regional wall motion abnormality on an echocardiogram is a common finding after a heart attack.
American Society of Echocardiography has divided the left ventricle into seventeen segments for assessment of regional wall motion abnormality. It may noted that though heart muscle is present in all four chambers of the heart, while assessing RWMA, usually only the lower left muscular chamber of the heart known as left ventricle is taken into account.
Wall motion abnormalities can also occur in the right ventricle (lower right muscular chamber of the heart). Since the interventricular septum which separates the right and left ventricle, is taken as part of the left ventricle, only free wall of the right ventricle is considered while mentioning wall motion abnormalities of the right ventricle. Wall motion abnormality of the right ventricle can be seen in heart attacks involving the right ventricle and in a condition known as pulmonary embolism, in which clots arising in other parts of the body move into the blood vessels of the lung.