Background: Coronary artery disease (CAD) represents a leading etiology of cardiovascular morbidity and mortality on a global scale. Echocardiography is a non-invasive, widely accessible imaging modality that enables comprehensive evaluation of cardiac structure and function in patients with established CAD.

Objectives: This investigation aimed to characterize echocardiographic alterations—specifically regional wall motion abnormalities (RWMA) and left ventricular ejection fraction (LVEF)—in a consecutive cohort of CAD patients presenting to tertiary care facilities in Delhi.

Methods: A cross-sectional observational design was employed, enrolling 95 consecutive patients (age >45 years) with confirmed CAD across three tertiary care institutions. Each participant underwent standard transthoracic echocardiography. RWMA pattern, segmental involvement, and LVEF were systematically documented. Statistical comparisons used Chi square and Student’s t-test/Mann-Whitney U test; significance was set at p < 0.05.

Results: RWMA were detected in 69 of 95 patients (72.6%). Mid and apical septal–anterior territories were most frequently involved. LVEF was reduced (<45%) in the majority of RWMA-positive patients, reaching nadir values of 15–20% in severely affected cases. Comorbid diabetes mellitus (DM) and hypertension (HTN) co-occurred in 44.2% of participants and correlated significantly with RWMA prevalence (χ² = 8.76, p = 0.003).

Conclusion: Echocardiography reliably identifies RWMA and depressed LVEF in CAD patients, with diagnostic accuracy of 80–90%. These findings reinforce its role as a first-line functional imaging modality in CAD evaluation.

KEYWORDS: Coronary Artery Disease, Echocardiography, Regional wall Motion Abnormality, Left Ventricular Ejection Fraction, Ischemic Heart Disease.