Chapter 15 looked at the global assessment of left ventricular (LV) dimensions and function. However, abnormalities of LV function can affect one or more specific areas of the LV wall and then the LV is said to show a regional wall motion abnormality (RWMA). RWMA is the result of coronary artery disease affecting the function of the myocardium, either because the blood supply to a particular area of myocardium has become reduced (ischaemia) or blocked altogether, causing death (necrosis) of the myocytes. The identification of RWMA by echo can therefore reveal a great deal about the status of the coronary circulation.