Hasan Alzahrani, Michael Y Woo, Chris Johnson, Paul Pageau, Scott Millington, Venkatesh Thiruganasambandamoorthy
BACKGROUND: Aortic stenosis (AS) is a common valve problem that causes significant morbidity and mortality. The goal of this study was to determine whether an emergency physician (EP) could determine severe AS by reviewing only two B-mode echocardiographic views (parasternal long axis (PSLA) and parasternal short axis (PSSA)) obtained by trained echocardiographers. METHODS: A convenience sample of 60 patients with no AS, mild/moderate AS or severe AS was selected for health record and echocardiogram review...
2015: Critical Ultrasound Journal
Dorota Sobczyk, Krzysztof Nycz, Pawel Andruszkiewicz
STUDY OBJECTIVE: To validate the practicality of focused echocardiography with A-F mnemonic performed by non-specialists in patients with suspected acute coronary syndrome (ACS). DESIGN: This prospective observational study was conducted in the Emergency Room within 12 months period. Study population consisted of consecutive patients with preliminary diagnosis of an ACS. The following data were analyzed: demographics, clinical condition, medical history, ECG, transthoracic echocardiography (TTE) and levels of cardiac necrotic markers...
March 26, 2015: Cardiovascular Ultrasound
Dorota Sobczyk, Krzysztof Nycz
STUDY OBJECTIVE: The purpose of the present study was to establish the accuracy of transthoracic echocardiography (TTE) in diagnosis of acute type A aortic dissection in comparison to computed tomography (CT), with reference to the intraoperative image. METHODS: The retrospective analysis included 178 patients referred to the cardiac surgery unit in our center due to acute type A dissection between 01-01-2008 and 31-12-2013, who underwent both TTE and CT. Intraoperative image was considered as a reference...
March 25, 2015: Cardiovascular Ultrasound
Andreea Călin, Monica Roşca, Carmen Cristiana Beladan, Roxana Enache, Anca Doina Mateescu, Carmen Ginghină, Bogdan Alexandru Popescu
Aortic stenosis has an increasing prevalence in the context of aging population. In these patients non-invasive imaging allows not only the grading of valve stenosis severity, but also the assessment of left ventricular function. These two goals play a key role in clinical decision-making. Although left ventricular ejection fraction is currently the only left ventricular function parameter that guides intervention, current imaging techniques are able to detect early changes in LV structure and function even in asymptomatic patients with significant aortic stenosis and preserved ejection fraction...
April 29, 2015: Cardiovascular Ultrasound
Hirotomo Sato, Tetsuro Ohta, Kimiko Hiroe, Seiji Okada, Koji Shimizu, Rinji Murakami, Kazuaki Tanabe
BACKGROUND: Quantitation of aortic regurgitation (AR) using two-dimensional (2D) echocardiography, including vena contracta width (VCW) measurement, is still challenging. Three-dimensional (3D) echocardiography can directly measure the vena contracta area (VCA), regardless of the rheological characteristics. We intended to assess the possibility of 3D vena contracta area (3DVCA) as well as 2D vena contracta area (2DVCA) in the assessment of AR severity. METHODS: Sixty-one patients with AR [17 female (32...
May 5, 2015: Cardiovascular Ultrasound
Andrew D M Grant, Kazuaki Negishi, Tomoko Negishi, Patrick Collier, Samir R Kapadia, James D Thomas, Thomas H Marwick, Brian P Griffin, Zoran B Popović
BACKGROUND: While echocardiographic grading of left ventricular (LV) diastolic dysfunction (DD) is used every day, the relationship between echocardiographic DD grade and hemodynamic abnormalities is uncertain. METHODS: We identified 460 consecutive patients who underwent transthoracic echocardiography within 24 h of elective left heart catheterization and had: normal sinus rhythm, no confounding structural heart disease, no change in medications between catheterization and echo, and complete echocardiographic data...
June 24, 2015: Cardiovascular Ultrasound
Mihai Strachinaru, Bas M van Dalen, Nicolas Van Mieghem, Peter P T De Jaegere, Tjebbe W Galema, Marielle Morissens, Marcel L Geleijnse
BACKGROUND: Symptoms in the elderly patients with severe aortic stenosis (AS) and co-morbidities seem to lack in specificity. Therefore, objective parameters for increased left ventricular(LV) filling pressures are needed. The aim of this study was to investigate the correlation between the septal, lateral and average E/e' ratio and the value of the N-terminal pro-hormone of brain natriuretic peptide (NT-proBNP). METHODS: Two-hundred-fifty consecutive symptomatic patients (mean age 80 ± 8 years, 52% men) with severe AS underwent transthoracic echocardiography and NT-proBNP measurement...
June 26, 2015: Cardiovascular Ultrasound
Pawel Andruszkiewicz, Dorota Sobczyk, Izabela Gorkiewicz-Kot, Ilona Kowalik, Remigiusz Gelo, Orest Stach
BACKGROUND: Use of preoperative echocardiography may help to identify patients with increased cardiac risk, who may benefit from modification of perioperative plan. The objective of our study was to evaluate the reliability of preoperative focused cardiac ultrasound (FoCUS) performed by an anaesthetist with basic ultrasound training and its impact on patient's management. METHODS: The prospective observational study was conducted in 159 adult patients, scheduled for elective operations...
November 20, 2015: Cardiovascular Ultrasound
M Kennedy Hall, E C Coffey, Meghan Herbst, Rachel Liu, Joseph R Pare, R Andrew Taylor, Sheeja Thomas, Chris L Moore
Emergency physician (EP)-performed focused cardiac ultrasound (EP FOCUS) has been increasingly recognized as a crucial tool to help clinicians diagnose and treat potentially life-threatening conditions. The existing literature demonstrates a variety of EP FOCUS applications and protocols; however, EP FOCUS is not taught, practiced, or interpreted consistently between institutions. Drawing on over 12 years of experience in a large-volume, high-acuity academic emergency department, we have developed a protocol for teaching and performing EP FOCUS known as "The 5Es," where each E represents a specific assessment for immediately relevant clinical information...
May 2015: Academic Emergency Medicine
Arun Nagdev, Michael B Stone
Detection of pericardial effusions using point-of-care focused echocardiography is becoming a common application for clinicians who care for critical patients. Identification of tamponade physiology is of great utility, as these patients require urgent evaluation and management. We describe techniques that the point-of-care clinician sonographer can use to determine the presence or absence of echocardiographic evidence of cardiac tamponade.
June 2011: Resuscitation
Bahaa M Fadel, Hatem Bakarman, Ziad Dahdouh, Giovanni Di Salvo, Dania Mohty
Mitral regurgitation (MR) is one of the most common valvular lesions that are readily identified by transthoracic echocardiography. Color Doppler imaging is the modality of choice for the recognition of MR, and it plays an important role in the assessment of regurgitation severity. Continuous wave (CW) Doppler is commonly used to interrogate the MR signal, and this modality can provide highly useful data regarding several physiological and pathological parameters. In this manuscript, we present a series of cases that illustrate the various hemodynamic parameters that can be derived from analysis of the CW Doppler signal of MR...
July 2015: Echocardiography
Simon Biner, Yan Topilsky, Shmuel Banai, Arie Steinvil, Yaron Arbel, Robert James Siegel, Roy Beigel, Gad Keren, Ariel Finkelstein
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become a treatment option for patients with severe aortic stenosis (AS) and high surgical risk. Assessment of symptoms in these patients is challenging because of advanced age, comorbidities, and limited physical activity. Noninvasive quantification of pulmonary capillary wedge pressure (PCWP) in candidates for TAVR may be helpful for risk stratification. The objective of the study was to create a model for estimation of PCWP by echo Doppler in patients with severe AS...
October 2015: Echocardiography
Neil J Pathak, Lorraine Ng, Turandot Saul, Resa E Lewiss
Endocarditis is a serious infection of the innermost muscle layer of the heart and can lead to significant mortality and morbidity. Echocardiography is instrumental to the timely diagnosis of this disease entity. We discuss the case of a patient presenting to the emergency department (ED) with fever of unclear etiology. The diagnosis of right-sided endocarditis was made using focused cardiac ultrasound. A 46-year-old man with a history of intravenous drug abuse presented to the ED complaining of fevers and headaches...
June 2013: American Journal of Emergency Medicine
J L Lobo, A Holley, V Tapson, L Moores, M Oribe, M Barrón, R Otero, D Nauffal, R Valle, M Monreal, R D Yusen, D Jiménez
BACKGROUND: Tricuspid annular plane systolic excursion (TAPSE) is an emerging prognostic indicator in patients with acute symptomatic pulmonary embolism (PE). METHODS AND RESULTS: We prospectively examined 782 normotensive patients with PE who underwent echocardiography in a multicenter study. As compared with patients with a TAPSE of > 1.6 cm, those with a TAPSE of ≤ 1.6 cm had increased systolic pulmonary artery pressure (53.7 ± 16...
July 2014: Journal of Thrombosis and Haemostasis: JTH
Michael Butterfield, Christine Riguzzi, Oron Frenkel, Arun Nagdev
A 61 year-old man presented to the Emergency Department for one day of nonspecific chest pain. Bedside echocardiogram performed by the emergency physician revealed normal systolic cardiac function but also showed a large ( > 10mm) bicornuate interatrial septal aneurysm (IASA) projecting into the right atrium (Figure 1, Video 1). There was no evidence of intraatrial thrombus. A formal echocardiogram performed later that day confirmed the diagnosis and also detected a patent foramen ovale (PFO) with a left-to-right shunt that reversed with Valsalva maneuver...
September 2014: Western Journal of Emergency Medicine
Thomas R Porter, Sasha K Shillcutt, Mark S Adams, Georges Desjardins, Kathryn E Glas, Joan J Olson, Richard W Troughton
No abstract text is available yet for this article.
January 2015: Journal of the American Society of Echocardiography
Danai Khemasuwan, Teerapat Yingchoncharoen, Pichapong Tunsupon, Kenya Kusunose, Ajit Moghekar, Allan Klein, Adriano R Tonelli
BACKGROUND: There is limited information on the utility of certain echocardiographic measurements, such as right ventricular (RV) strain analysis, in predicting mortality in patients with acute pulmonary embolism (PE). METHODS: A total of 211 patients with acute PE admitted to a medical intensive care unit (ICU) were retrospectively identified. Echocardiographic variables were prospectively measured in this cohort. The focus was on ICU, hospital, and long-term mortality...
March 2015: Journal of the American Society of Echocardiography
Brian G Choi, Reza Sanai, Benjamin Yang, Heather A Young, Ramesh Mazhari, Jonathan S Reiner, Jannet F Lewis
BACKGROUND: Studies with other imaging modalities have demonstrated a relationship between contrast transit and cardiac output (CO) and pulmonary vascular resistance (PVR). We tested the hypothesis that the transit time during contrast echocardiography could accurately estimate both CO and PVR compared to right heart catheterization (RHC). METHODS: 27 patients scheduled for RHC had 2D-echocardiogram immediately prior to RHC. 3 ml of DEFINITY contrast followed by a 10 ml saline flush was injected, and a multi-cycle echo clip was acquired from the beginning of injection to opacification of the left ventricle...
October 31, 2014: Cardiovascular Ultrasound
A Ng, J Swanevelder
No abstract text is available yet for this article.
March 2015: British Journal of Anaesthesia
Emeric Gallard, Jean-Philippe Redonnet, Jean-Eudes Bourcier, Dominique Deshaies, Nicolas Largeteau, Jeanne-Marie Amalric, Fouad Chedaddi, Jean-Marie Bourgeois, Didier Garnier, Thomas Geeraerts
OBJECTIVE: The etiologic diagnosis of acute dyspnea in the emergency department (ED) remains difficult, especially for elderly patients or those with previous cardiorespiratory medical history. This may lead to inappropriate treatment and potentially a higher mortality rate. Our objective was to evaluate the performance of cardiopulmonary ultrasound compared with usual care for the etiologic diagnosis of acute dyspnea in the ED. METHODS: Patients admitted to the ED for acute dyspnea underwent upon arrival a cardiopulmonary ultrasound performed by an emergency physician, in addition to standard care...
March 2015: American Journal of Emergency Medicine
2015-01-14 13:10:06
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