Evaluation of left ventricular wall motion

Abstract

The left ventricle must be depicted in the correct cross-section to assess left ventricular wall motion. Often, the apex is not a true apex, and the left ventricle size is underestimated. The long axis of the left ventricle should be enlarged as much as possible by using an echo bed or by imaging during inspiration as well as expiration. The short axis should be observed at the level of the papillary muscles to make sure that both papillary muscles are equally delineated. If they are not equal, there is a possibility of oblique swing, and wall motion evaluation cannot be done properly. Regional wall motion abnormalities and myocardial properties on short-axis and long-axis images from the apex should be evaluated. In old myocardial infarction, increased intensity and decreased wall thickness on the intimal side are also important findings. If the findings are not consistent with coronary artery supply, cardiac sarcoidosis or takotsubo cardiomyopathy should be considered. In such cases, the electrocardiogram should also be referred to. Left ventricular contractility is assessed using the method of disks (MOD). This is a method for determining the volume of the left ventricle by dividing it into 20 elliptical columns. Many people misunderstand MOD as “modify” because it is displayed on echocardiography machines, but this is a misnomer.