Comparison of Ultraportable Cardiac Echocardiography with Physical Examination for Diagnosis and Management during Cardiac Consultation Rounds
Mehmet Ali Astarcıoğlu, Taner Şen, Celal Ki̇li̇t, Halil İbrahim Durmuş, Adnan Doğan, Türkan Paşalı Ki̇li̇t, Afşin Parspur, Mehmet Yaymacı, Muhammed Oylumlu
Keywords: Hand-carried cardiac ultrasound, point-of-care screening
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. Definitive diagnosis, management change, and modifying diagnostic workup were also assessed. Results: There were 196 CV findings detected with an SED in this patient population. Of these, PE failed to detect 41% of the overall CV findings 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 significant 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.