BackgroundCardiovascular urgencies are frequent reasons for seeking medical care. Prompt and
accurate medical diagnosis is critical to reduce the morbidity and mortality of
these conditions.ObjectiveTo evaluate the use of a pocket-size echocardiography in addition to clinical
history and physical exam in a tertiary medical emergency care.MethodsOne 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.ResultsThe 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.ConclusionThe focused echocardiography with pocket-size equipment in the emergency care may
allow a prompt diagnosis and, consequently, an earlier initiation of the
therapy.
The training proposed enabled residents to perform FCU with HCD, and their findings were in good agreement with those of a cardiologist specialized in echocardiography.
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