Clinical InvestigationEchocardiography at the “Point of Care”Usefulness of a New Miniaturized Echocardiographic System in Outpatient Cardiology Consultations as an Extension of Physical Examination
Section snippets
Methods
This study took place at two tertiary hospitals in two different countries (University Hospital San Carlos, Madrid, Spain, and Hospital da Luz, Lisbon, Portugal). The MS used was the V-Scan (GE Vingmed Ultrasound AS, Horten, Norway). This ultrasound device consists of a display unit (135 × 73 × 28 mm) connected to a broad-bandwidth phased-array probe (1.7–3.8 MHz; 120 × 33 × 26 mm). Its total weight (unit and probe) is 390 g. The total possible scanning time is 1 hour with a fully charged
Results
We studied 189 patients (mean age, 53 ± 16 years; age range, 14–89 years; 99 male [52.4%], 90 female [47.6%]).
Discussion
Since their development about 40 years ago, the use of hand-held echocardiographic systems has been a controversial issue,6, 7, 8, 9, 10, 11, 12, 13, 14 specifically with regard to their diagnostic accuracy, the clinical scenarios in which they should be used, and the identification of their potential users and their competence level.17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28
Nowadays, the first issue is no longer an important subject of debate. Technological evolution has led to the
Conclusions
The new MS in outpatient cardiology consultations as an extension of physical examination caused a negligible increase in the duration of the consultations. It showed additive clinical value over the physical examination, contributing to an increased number of diagnoses, reducing the performance of unnecessary conventional echocardiographic studies, increasing the number of adequate echocardiograms, and allowing many patients to be released from the outpatient clinic without the need for
References (35)
- et al.
ACCF/ASE/ACEP/ASNC/SCAI/SCCT/SCMR 2007 appropriateness criteria for transthoracic and transesophageal echocardiography: a report of the American College of Cardiology, American Society of Echocardiography, American College of Emergency Physicians, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and the Society for Cardiovascular Magnetic Resonance endorsed by the American College of Chest Physicians and the Society of Critical Care Medicine
J Am Coll Cardiol
(2007) - et al.
Physician performed point-of-care echocardiography using a laptop platform compared with physical examination in the cardiovascular patient
J Am Coll Cardiol
(2001) The physical examination of the future: echocardiography as part of the assessment
ACC Curr J Rev
(1998)- et al.
Usefulness of a hand-held ultrasound device for bedside examination of left ventricular function
Am J Cardiol
(2002) - et al.
Cardiac physical diagnosis in the digital age: an important but increasingly neglected skill (from stethoscopes to microchips)
Am J Cardiol
(2009) - et al.
Comparative increases in utilization rates of ultrasound examinations among radiologists, cardiologists, and other physicians from 1993 to 2001
J Am Coll Radiol
(2004) - et al.
Feasibility of real-time echocardiographic evaluation during patient transport
J Am Soc Echocardiogr
(2003) - et al.
Hand-carried ultrasound-guided pericardiocentesis and thoracentesis
J Am Soc Echocardiogr
(2003) - et al.
How useful is hand-carried bedside echocardiography in critically ill patients?
J Am Coll Cardiol
(2001) - et al.
Unsuspected clinically important findings detected with a small portable ultrasound device in patients admitted to a general medicine service
J Am Soc Echocardiogr
(2003)