Focused Cardiac Ultrasound: Recommendations from the American Society of Echocardiography

Spencer, Kirk T.; Kimura, Bruce J.; Korcarz, Claudia E.; Pellikka, Patricia A.; Rahko, Peter S.; Siegel, Robert J.

doi:10.1016/j.echo.2013.04.001

Cited by 504 publications

(463 citation statements)

References 107 publications

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“…Dato l'aumento delle richieste di ETT nella maggior parte delle discipline internistiche, associato alla continua esigenza dell'uso dell'ecocardiogramma da parte di specialisti non cardiologi, l'American Society of Echocardiography (ASE) ha definito, in un position paper, gli standard minimi di competenza per i tecnici ecocardiografici e per i medici non cardiologi che intendono interessarsi alla diagnostica ecografica cardiovascolare nel contesto delle loro specialità (9). L'ASE, inoltre, ha definito "Focus Cardiac Ultrasound" (FCU) l'esame eseguito dal medico specialista non cardiologo mirato alla valutazione del sistema cardiovascolare rappresentato da uno stretto elenco di potenziali diagnosi in ambienti clinici specifici (10). Anche l'European Association of Cardiovascular Imaging (EACVI) ha recentemente riconosciuto che i cardiologi non devono essere gli unici medici in grado di eseguire un FCU particolarmente in condizioni cliniche tipiche di pertinenza specialistica (11).…”

Section: Ecocardiografia O Ecocardioscopia?unclassified

“…Queste realtà, però, sono più diffuse in ambienti intensivisti e un po' meno in quelli internistici (7)(8)(9)(10), mentre appaiono ancora poco comuni nei contesti nefrologici. Esiste, effettivamente, una serie di svantaggi o limitazioni da considerare prima di investire in un'attività diagnostica di questa portata.…”

Section: Vantaggi E Svantaggi Dell'ecocardioscopia In Nefrologiaunclassified

See 1 more Smart Citation

Echocardioscopy in Cardiovascular Stratification of Chronic Kidney Diseases: The Nephrologist is the Protagonist

Rivera

Pascalis

Floccari

et al. 2016

Giornale di Tecniche Nefrologiche e Dialitiche

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Giornale di Tecniche Nefrologiche e Dialitiche 2016; 28 (2): 122-127 fattori di rischio "tradizionali", come età, ipertensione arteriosa, diabete, dislipidemie, obesità, tabagismo e così via e quelli "specifici" dell'uremia, come anemia, iperomocisteinemia, disfunzione endoteliale e stato infiammatorio (3). Tuttavia, alcuni fattori tipici della MRC, come il controllo pressorio e la gestione della volemia, hanno un effetto diretto sul miocardio, generando alterazioni morfologiche e funzionali come l'ipertrofia ventricolare sinistra, il rimodellamento cardiaco, la dilatazione cavitaria, la fibrosi miocardica e lo scompenso sistolico-diastolico (4). Inoltre, i noti disturbi del metabolismo minerale e l'iperparatiroidismo secondario conducono alle calcificazione vascolari e valvolari (5), aumentando da 3 a 4 volte il rischio di mortalità CV degli uremici (6).L'incremento di queste complicanze nella MRC ha progressivamente incoraggiato i nefrologi ad acquisire nel proprio background le competenze tecnico-strumentali per la diagnosi della patologia cardiaca. Infatti, sia sul territorio nazionale che all'estero, sono sempre più presenti strutture operative nefrologiche che si occupano di diagnostica cardiovascolare e di stratificazione di rischio di pazienti nefropatici. Il ricorso all'ecocardiografia al di fuori degli ambienti cardiologici non è solo una prerogativa nefrologica, ma la tendenza è percepibile anche in altri settori come quelli internistici, generalistici e intensivisti. I IntroduzioneLa patologia cardiovascolare (CV) rappresenta la principale causa di morbidità e di mortalità nei pazienti affetti da malattie renali croniche (MRC) (1). L'Annual Data Report dell'USRDS (2) riporta che più del 38% dei decessi tra i pazienti in trattamento dialitico avviene come conseguenza di patologie CV. Dal punto di vista fisiopatologico, il fenomeno è la conseguenza dell'interazione tra Echocardioscopy in cardiovascular stratification of chronic kidney diseases: the nephrologist is the protagonist Cardiovascular disease (CV) is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). The increase in cardiac complications in patients with CKD has encouraged nephrologists to acquire the cardiac diagnostic competences in the use of ultrasound. A formal echocardiographic approach requires standard times and the immediate availability of the cardiac-sonographer. Therefore, a goal-directed cardiac ultrasound and a focused echocardiogram or echocardioscopy strategy were created specifically tailored to the non-cardiologists as well as internists, interventists and intensivists. The concept of echocardioscopy has been incompletely evaluated and it is necessary to find a curricular program to grant proficiency. The introduction of echocardioscopy in the nephrologist's tasks has the advantage of widening the spectrum of the diagnostic of cardiac complications in CKD patients, but also confers several technical limitations. The aim of this revision is to analyze the use of the cardiac ultrasound ...

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Section: Ecocardiografia O Ecocardioscopia?unclassified

Section: Vantaggi E Svantaggi Dell'ecocardioscopia In Nefrologiaunclassified

Echocardioscopy in Cardiovascular Stratification of Chronic Kidney Diseases: The Nephrologist is the Protagonist

Rivera

Pascalis

Floccari

et al. 2016

Giornale di Tecniche Nefrologiche e Dialitiche

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“…Significant dilation/aneurism of ascending aorta (45 mm) can be visually detected; nevertheless, aortic dissection is not included in international recommendation for focused echocardiography needing its recognition a higher level of competence. 4 …”

Section: The Bedside Cardiac Examination Detecting Alteration Of Cardmentioning

confidence: 99%

“…Bedside echocardiography (also reported as focused echocardiography or point of care echocardiography) is a clinical approach performed to answer specific questions arising from anamnesis and physical examination: 4 significantly enlarged cardiac chambers, moderately or severely reduced left and right ventricular (LV and RV) function, detection of pericardial effusion and signs of tamponade, inferior vena cava size and dynamics can be directly recognized mainly in the perspective of presence/absence of gross abnormalities. Bedside echocardiography of course cannot substitute a standard examination, where high competence is required to grade pathologies and to diagnose even mild abnormalities.…”

Section: Introductionmentioning

confidence: 99%

Bedside echocardiography in internal medicine: which key questions and answers for our decision-making?

et al. 2015

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The advent of portable equipment in the last years has brought ultrasound (US) technology available at patient bedside, giving the opportunity to non-cardiologists to extend cardiac assessment based on physical examination. Bedside echocardiography is a question-driven examination, where simple and often dichotomous answers are searched. It is performed using phased-array probes and bi-dimensional images are visually evaluated to obtain information regarding cardiac size and function, presence of pericardial effusion, gross valvular diseases. Although this approach cannot in any case substitute a standard 2D color-Doppler echocardiography, bedside echocardiography has been demonstrated to maintain a good diagnostic accuracy when limited to basic questions, even in the hands of short-trained non cardiologist physicians. At present the bedside US approach is widely used in different settings and focused echocardiography takes part together with US explorations of lung, abdomen and deep veins in an integrated perspective that perfectly fits with the holistic approach of the internist. In this context we address two typical scenarios encountered in the internal medicine divisions -the patient presenting with dyspnea or nonpost-traumatic hypotension -showing the main questions we can ask to bedside echocardiography for a rapid identification of the determinants of symptoms and consequently for a therapeutic choice based on more objective evidence.

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“…However, the obtained information should be interpreted in the context of each patient (MOORE & COPEL, 2011). According to the ASE, in well-trained hands, focused echocardiography can be regarded as an accurate method, with reliable findings in the evaluation of cardiac structure and function (SPENCER et al, 2013). Lucina et al FATE is indicated for animals that have been admitted to emergency care with thoracic trauma, dyspnea, hypotension or shock.…”

Section: Introductionmentioning

confidence: 99%

Use of focus assessed transthoracic echocardiography (FATE) in the veterinary emergency room

2017

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The use of bedside focus assessed transthoracic echocardiography (FATE) is widespread in human medicine, and the potential for veterinary medicine has only recently been investigated. Focused echocardiographic examination can be beneficial in critically ill patients compared to other bedside diagnostic methods, as well as facilitating rapid therapeutic approaches in the emergency room. The aim of this review is to discuss FATE and identify its main applications in veterinary medicine. In this context, FATE has proved to be benefical even when carried out by a non-cardiologist physician or veterinarian. However, a few references on this subject exist in the veterinary literature and there is still a need for standardization of this technique for use in animals.

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Focused Cardiac Ultrasound: Recommendations from the American Society of Echocardiography

Cited by 504 publications

References 107 publications

Echocardioscopy in Cardiovascular Stratification of Chronic Kidney Diseases: The Nephrologist is the Protagonist

Echocardioscopy in Cardiovascular Stratification of Chronic Kidney Diseases: The Nephrologist is the Protagonist

Bedside echocardiography in internal medicine: which key questions and answers for our decision-making?

Use of focus assessed transthoracic echocardiography (FATE) in the veterinary emergency room

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