Focused echocardiography on patients with chest pain or dyspnea using a pocket size device in Emergency Department

doi:10.3877/cma.j.issn.1672-6448.2016.06.014

Abstract

Abstract:

Objective

To study the clinical usefulness of pocket size echocardiography for a cardiac focused ultrasonography in evaluating patients complaining chest pain or dyspnea in Emergency Department.

Methods

Two hundred and seventy-one patients in Emergency Department of Fuwai Hospital were enrolled into this study from January to October in 2014. Patients underwent transthoratic echocardiography with a protocol focusing on the cardiac chamber diameters, left ventricular systolic function, regional wall motion abnormalities, pericardium and ascending aorta using GE Vscan and reconfirmed by GE Vivid i immediately. The results from difference diagnostic tools were compared with Chi Square test. Independent t test was applied to compare the consuming time differences from GE Vscan and GE Vivid i, from junior and senior echocardiographers respectively.

Results

It was possible to obtain good-quality images using pocket size echocardiography device in all patients. Regional wall motion abnormalities were found in 91 patients; left ventricular systolic dysfunction was discovered in 37 patients; 3 patients were with pericardial effusion; and 14 patients were found with ascending aorta dissection. Neither left ventricular systolic dysfunction nor regional wall motion abnormalities were found in the remaining individuals. One case of regional wall motion abnormalities and a case of left ventricular systolic dysfunction were missed by GE Vscan. However, no significant difference was observed between Vscan and Vivid i (χ²=0.03, P>0.05). The scanning time for each patient was 1-5 minutes and there was no significant time difference between Vscan and Vivid i (t=-1.478, P>0.05). Senior echocardiographers took less time for exams than junior doctors [(2.6±1.4) min vs (3.5±1.8) min, t=-2.41, P<0.05].

Conclusions

The pocket size ultrasound equipment was able to obtain reliable information of important cardiovascular structures, function and hemodynamics from patients complaining chest pain or dyspnea. Focused echocardiography for these undiagnosed patients admitted to Emergency Department allows a quick and accurate diagnosis, avoiding missed diagnosis, may have the potential to improve in-hospital diagnostic procedures.

Key words: Echocardiography, Chest dyspnea, Chest pain

Xin Quan, Yan Sun, Hui Li, Jianpeng Wang, Hao Wang. Focused echocardiography on patients with chest pain or dyspnea using a pocket size device in Emergency Department[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(06): 471-475.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2016.06.014

https://chaosheng.cma-cmc.com.cn/EN/Y2016/V13/I06/471

Figures/Tables 2

References 19

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方法	例数	超声心动图检查结果（例）					检查用时（min，±s）
方法	例数	节段性室壁运动异常	心包积液	左心室收缩功能减低	主动脉夹层	未见异常	检查用时（min，±s）
Vscan	271	91	3	37	14	126	3.0±1.2
Vivid i	271	92	3	38	14	124	3.0±1.3
检验值	?	χ²=0.03					t=-1.478
P值	?	>0.05					>0.05

方法	例数	超声心动图检查结果（例）					检查用时（min，±s）
方法	例数	节段性室壁运动异常	心包积液	左心室收缩功能减低	主动脉夹层	未见异常	检查用时（min，±s）
Vscan	271	91	3	37	14	126	3.0±1.2
Vivid i	271	92	3	38	14	124	3.0±1.3
检验值	?	χ²=0.03					t=-1.478
P值	?	>0.05					>0.05

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