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. 2014 Dec;103(6):530-7.
doi: 10.5935/abc.20140158. Epub 2014 Oct 28.

Focused Cardiac Ultrasound Using a Pocket-Size Device in the Emergency Room

[Article in English, Portuguese]
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Free PMC article

Focused Cardiac Ultrasound Using a Pocket-Size Device in the Emergency Room

[Article in English, Portuguese]
Frederico José Neves Mancuso et al. Arq Bras Cardiol. .
Free PMC article

Abstract

Background: Cardiovascular urgencies are frequent reasons for seeking medical care. Prompt and accurate medical diagnosis is critical to reduce the morbidity and mortality of these conditions.

Objective: To evaluate the use of a pocket-size echocardiography in addition to clinical history and physical exam in a tertiary medical emergency care.

Methods: One hundred adult patients without known cardiac or lung diseases who sought emergency care with cardiac complaints were included. Patients with ischemic changes in the electrocardiography or fever were excluded. A focused echocardiography with GE Vscan equipment was performed after the initial evaluation in the emergency room. Cardiac chambers dimensions, left and right ventricular systolic function, intracardiac flows with color, pericardium, and aorta were evaluated.

Results: The mean age was 61 ± 17 years old. The patient complaint was chest pain in 51 patients, dyspnea in 32 patients, arrhythmia to evaluate the left ventricular function in ten patients, hypotension/dizziness in five patients and edema in one patient. In 28 patients, the focused echocardiography allowed to confirm the initial diagnosis: 19 patients with heart failure, five with acute coronary syndrome, two with pulmonary embolism and two patients with cardiac tamponade. In 17 patients, the echocardiography changed the diagnosis: ten with suspicious of heart failure, two with pulmonary embolism suspicious, two with hypotension without cause, one suspicious of acute coronary syndrome, one of cardiac tamponade and one of aortic dissection.

Conclusion: The focused echocardiography with pocket-size equipment in the emergency care may allow a prompt diagnosis and, consequently, an earlier initiation of the therapy.

Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Vscan device (GE Healthcare) used in this study.
Figure 2
Figure 2
Patient complaining of dyspnea. Portable cardiac ultrasound revealed dilated cardiomyopathy with systolic dysfunction of the left ventricle (LV) and a thrombus in apical region (arrow) in the apical window.
Figure 3
Figure 3
Significant pericardial effusion (DP) in the subcostal plane showing signs of restricted ventricular filling in a patient with cardiac tamponade. RV: right ventricle; LV: left ventricle.
Figure 4
Figure 4
Dilatation of the right ventricle (RV) and rectification of the interventricular septum in the parasternal view, in a patient with dyspnea and suspected pulmonary thrombosis.

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References

    1. Piegas LS, Feitosa G, Mattos LA, Nicolau JC, Rossi JM, Neto, Timerman A, et al. Sociedade Brasileira de Cardiologia Diretriz da Sociedade Brasileira de Cardiologia sobre tratamento do infarto agudo do miocárdio com supradesnível do segmento ST. Arq Bras Cardiol. 2009;93(6) supl. 2:e179–e264. - PubMed
    1. Montera MW, Almeida RA, Tinoco EM, Rocha RM, Moura LZ, Réa-Neto A, et al. Sociedade Brasileira de Cardiologia II Diretriz brasileira de insuficiência cardíaca aguda. Arq Bras Cardiol. 2009;93(3) supl.3:1–65. - PubMed
    1. Pitts SR, Niska RW, Xu J, Burt CW. National Hospital Ambulatory Medical Care Survey: 2006 emergency department summary. Natl Health Stat Report. 2008;(7):1–38. - PubMed
    1. Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee Heart disease and stroke statistics-2010 update: a report from the American Heart Association. Circulation. 2010;121(7):e46–e215. Erratum in: Erratum in: Circulation. 2010;121(12):e260. - PubMed
    1. Pope JH, Aufderheide TP, Ruthazer R, Woolard RH, Feldman JA, Beshansky JR, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med. 2000;342(16):1163–1170. - PubMed

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