WAMAMI: emergency physicians can accurately identify wall motion abnormalities in acute myocardial infarction - 13/12/19
, Tania D. Strout, PhD, RN, MS a, c, Randy M. Kring, MD a, c, Laura Director d, Samip C. Vasaiwala, MD b, c, David C. Mackenzie, MDCM a, cAbstract |
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.
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| ☆ | Presented at the Society for Academic Emergency Medicine Annual Meeting, May 2018, Indianapolis IN. |
Vol 37 - N° 12
P. 2224-2228 - décembre 2019 Retour au numéro
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