Comparison of Ultraportable Cardiac Echocardiography with Physical Examination for Diagnosis and Management during Cardiac Consultation Rounds

Abstract

Introduction: The purpose of this study was to compare the results of physical examinations (PEs) performed by a cardiologist with the results of point-of-care echocardiography for the diagnosis and management of patients during cardiac consultation rounds. Patients and Methods:In all, 265 hospitalized consecutive patients from non-cardiac units (age, 62 ± 11; male, 56%) were included after complete cardiovascular (CV) examination by a consulting cardiologist. After the PE, the consulting cardiologist imaged each patient using a hand-carried cardiac ultrasound (HCU). All patients subsequently underwent a study with a standard echocardiographic device (SED) as the gold standard, performed on an upper-end platform. Defi nitive diagnosis, management change, and modifying diagnostic workup were also assessed.Results: There were 196 CV fi ndings detected with an SED in this patient population. Of these, PE failed to detect 41% of the overall CV fi ndings and HCU missed 23% of the overall CV pathology. Overall, HCU had an effect on patient treatment decisions in 149 patients (56%); 42% had a change in medical therapy and 21% had a change in their diagnostic workup (most with changes in both). Conclusion:HCU echocardiographic assessment during consultation rounds improved the detection of signifi cant CV pathology. Also, a direct assessment of cardiac function and anatomy at the bedside by an experienced cardiologist with HCU as a routine adjunct to PE results in an important change in clinical management and diagnostic workup during consultation.Key Words: Hand-carried cardiac ultrasound; point-of-care screening Kardiyak Konsültasyonlar Esnasında Tanı ve Tedavide Taşınabilir Ekokardiyografi Cihazları ile Birlikte Fizik Muayenenin Karşılaştırılması ÖZETGiriş: Bu çalışmanın amacı, kardiyak konsültasyon esnasında tanı ve tedavi üzerinde ekokardiyografi sonuç-ları ile kardiyolog tarafından gerçekleştirilen fi zik muayene sonuçlarını karşılaştırmaktır.

Influence of Personalized Health Management Model Based on Internet Mode on Self-Management Ability and Life Quality of Patients with Chronic Diseases Undergoing Physical Examination

“…This study advocates peer education, fully considers the importance of the role of family members, encourages family members to participate, and takes the physical examiner as the main body and the family as the center. The physical examiner feels the care and attention of the family members, which not only enhances the confidence in overcoming the disease, but also helps to improve the ability of self-management and promote the rehabilitation of the disease [ 40 , 41 ]. Personalized health management takes full account of the personal living habits and characteristics of physical examiners, which can reduce their rebellious psychology caused by behavior restrictions, enhance their bad mood, be more easily accepted by physical examiners, improve their spirit of ownership, and increase their own participation [ 42 – 44 ].Our study still has some shortcomings.…”