Comparison of Regional Wall Motion Abnormalities in STEMI and NSTEMI Patients at Mardan Medical Complex

Abstract

Objectives: This study aims to determine and compare regional wall motion abnormalities (RWMA) in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI), along with associated common complications.

Methodology: A comparative cross-sectional study was conducted in the cardiology department of Mardan Medical Complex from June to November 2023. Patients diagnosed with acute myocardial infarction (both STEMI and NSTEMI) were included. Data were collected using a convenient sampling technique. Ethical approval was obtained prior to data collection, which was performed using a predesigned questionnaire. RWMA assessments were conducted by an expert in accordance with the American Society of Echocardiography guidelines using a Toshiba Xario200 Echocardiography machine. Data were analyzed using SPSS 22.

Results: Out of 274 patients, 156 (56.9%) were male and 118 (43.1%) were female, with 136 (50%) from the STEMI group and 136 (50%) from the NSTEMI group. The mean age of the respondents was 57.4 ± 13.1 years. RWMA was observed in both types of MI, with significant differences (p < 0.05) found between STEMI and NSTEMI in several segments: basal anterior (5.83% vs. 1.82%), basal anteroseptal (16.23% vs. 2.55%), basal anterolateral (14.59% vs. 3.23%), basal inferior (18.61% vs. 2.91%), apical anterior (5.09% vs. 1.45%), and apical septal (5.46% vs. 1.82%). Severe left ventricular systolic dysfunction was observed in only 2 (0.73%) STEMI patients, while severe pulmonary hypertension was more common in NSTEMI patients.

Conclusion: RWMA is a common finding in STEMI patients. Echocardiography plays a crucial role in the early detection of RWMA, which can improve prognosis and reduce the risk of complications.