Cardiac USG for Dyspneic Patients Performed in Emergency Departments

Abstract

GirişHastabaşı USG Acil Tıp Kliniklerinde hastanın ayırıcı tanı ve tedavisinde giderek artan hızla kullanılmaya başlanmıştır. Hayatı tehdit eden birçok durumda yalnız fizik bakı bulguları ile yetinmek yerine doğrudan ilgili sistem, organ ve yapılar hakkında görsel ve ölçülebilir bilgiyi verir. Acil servis yaşamda kalım için zaman ve karar ilişkisini kullanır. Kalp yaşam, yaşam hasta kazanımıdır. Kap hertürlü acil durumda doğrudan ya da dolaylı şekilde etkilenir. Kardiyak USG temel Ekokardiyografi prensibini içerir. Şok, perikardiyal tamponat, aort disseksiyonu, pulmoner emboli, kapak anomalileri, kardiyak anevrizma, sistolik ve/veya diastolik kalp yetmezliği, akut ve/veya kronik korpulmonale ayırıcı tanısını Acil Tıp Uzmanının hızla ayırd edebilmesini ve kardiyopulmoner resussi- AbstractObjective: The aim is to investigate the effi ciency of use of cardiac ultrasonography in patients brought in with respiratuary stress to the Emergency Department (ED). Materials and Methods: This prospective study included 72 patients between January 2009 and February 2010 in a third degree ED. It was accepted by the Ethics Committee of the University and informed signed consent was obtained from every patient after explanation. Age, sex, consultation, Killip and New York classifi cation, duration in ED, fi nalization, cost in ED, whether there are echocardiography and computerized tomography (CT) results and LVD (left ventricule diastole, LVS (left ventricule systole) longitudinal total lengths evaluated by a blind emergency physician (EP) were evaluated. All cardiac screens were archived by printing with lengths. The sonographic machine used was GE Proseries Logic 200. X2 and Fisher's Exact test for the relations between categorical data and Mann-Whitney U test for comparison in dual groups were used in statistical analysis. Results: There was a signifi cant diff erence in LVD and LVS lengths between the patients admitted to the cardiology clinic and the others (p=0.001, p=0.001). There was no signifi cant diff erence found in the same groups for the duration, cost in ED (p=0.778, p=0.194), the fi nalization of patients admitted to cardiology 40.3% (n=29), chest diseases 31.9% (n=23) and others. Conclusion: Cardiac USG performed in ED is helpful in the diff erential diagnosis and evaluation of the left ventricular sizes in dyspneic patients and is eff ective in management and fi nalization. (JAEM 2011; 10: 22-6)