RWMA

Regional wall motion abnormality may be acute or chronic. Acute RWMA has normal myocardial thickness and can be harder to pick. Chronic RWMA due to scar formation leads to a thin myocardium and sometimes paradoxical movement. 

The best way to pick RWMA is to observe the LV at the pap muscle level in PSAx. Focus on the anechoic cavity and let your peripheral vision observe the walls moving into the centre. Over time you will notice the walls which are not contracting. 

PSAx: acute inferior RWMA

A4c: chronic RWMA (note very thin walls at apex