Is segmental ventricular wall motion abnormality equivalent to coronary artery disease Echocardiography is often used to evaluate the heart for localized ventricular wall motion abnormalities to detect known or suspected coronary artery disease. Echocardiography of ischemic myocardium shows reduced or absent ventricular wall motion or paradoxical motion, increased segmental echodensity, absent motion, and thinning of diastolic wall thickness after myocardial infarction or chronic myocardial ischemia causing myocardial fibrosis and scar formation. In ischemic heart disease, this abnormal segmental ventricular wall motion is a common feature of acute and chronic myocardial ischemia and myocardial infarction. Segmental ventricular wall motion abnormalities demonstrated by 2D echocardiography correlate well with coronary artery distribution, pathology and perfusion. It should be emphasized that ventricular wall motion is usually enhanced in non-ischemic areas in patients with acute myocardial ischemia, and therefore left ventricular ejection fraction may be normal. Segmental ventricular wall motion abnormalities are a characteristic echocardiographic manifestation of myocardial ischemia and myocardial infarction, and although the specificity of this feature is generally considered to be high, it is less sensitive in patients with underlying coronary artery disease. It is also important to recognize that abnormal ventricular wall motion is not unique to coronary artery disease; left bundle branch block, thoracic abnormalities, pulmonary disease, right ventricular pressure and volume overload, right ventricular pacing, and open heart surgery can also present with abnormal septal motion, and limited encapsulated pericardial adhesions can cause segmental ventricular wall motion abnormalities.