400 results match your criteria Bedside Ultrasonography Cardiac Evaluation

A Rare Cause of Chest Pain Identified on Point-of-care Echocardiography: A Case Report.

Clin Pract Cases Emerg Med 2022 May;6(2):1-4

Arrowhead Regional Medical Center, Department of Emergency Medicine, Colton, California.

Introduction: Cardiac masses are a rare cause of chest pain. They can often be missed on a chest radiograph performed to evaluate non-specific chest pain and are not readily evaluated with traditional laboratory testing. However, these masses can be visualized with point-of-care ultrasound. Read More

View Article and Full-Text PDF

Estimation of Right Atrial Pressure Using a Portable Handheld Ultrasound.

Am J Med 2022 May 27. Epub 2022 May 27.

Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida; Malcom Randall Veterans Administration Medical Center, Gainesville, Florida. Electronic address:

Background: Handheld ultrasound devices are increasingly used by clinicians for their ease of use and portability. Their utility for estimating right atrial pressure (RAP) is poorly described.

Methods: This prospective study enrolled 50 consecutive patients presenting for outpatient right heart catheterization (RHC). Read More

View Article and Full-Text PDF

Phenotyping exercise limitation of patients with Interstitial Fibrosing Lung Disease: the importance of exercise hemodynamics.

Pulmonology 2022 May 11. Epub 2022 May 11.

University Department of Respiratory Medicine, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle University of Thessaloniki, Thessaloniki, Greece.

Introduction And Objective: Left-heart dysfunction and pulmonary vasculopathy are increasingly recognized as contributing factors of exercise capacity limitation in interstitial fibrosing lung disease (IFLD). Moreover, the clinical significance of exercise pulmonary hypertension (ePH) in pulmonary and cardiac diseases has been documented, representing a risk factor for decreased exercise capacity and survival, progression to resting pulmonary hypertension (PH) and overall clinical worsening. We conducted a prospective study aiming at: (a) assessing the prevalence of PH and ePH in a cohort of 40 functionally limited patients with IFLD, (b) determining the post-capillary (postC) or pre-capillary (preC) etiology of either PH or ePH in this cohort, and (c) examining the correlations between invasively and non-invasively measured exercise variables among hemodynamic groups. Read More

View Article and Full-Text PDF

A Blueprint for an Integrated Point-of-Care Ultrasound Curriculum for Nephrology Trainees.

Kidney360 2021 10 13;2(10):1669-1676. Epub 2021 Aug 13.

Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, Florida.

Point-of-care ultrasonography (POCUS) is a limited ultrasound study performed by the clinician at the bedside as a component or an adjunct to physical examination. POCUS has multiple applications in nephrology practice, including evaluation of obstructive uropathy, objective assessment of volume status, arteriovenous access assessment, and procedural guidance. However, unlike specialties such as emergency medicine, POCUS training is not yet integrated into most nephrology fellowship curricula, and the sonographic applications taught vary widely among fellowship programs. Read More

View Article and Full-Text PDF
October 2021

Comprehensive Assessment of Fluid Status by Point-of-Care Ultrasonography.

Kidney360 2021 08 27;2(8):1326-1338. Epub 2021 May 27.

University of Pennsylvania, Philadelphia, Pennsylvania.

The management of complex fluid and electrolyte disorders is central to the practice of nephrologists. The sensitivity of physical examination alone to determine fluid status is limited, precluding accurate clinical decision making. Point-of-care ultrasonography (POCUS) is emerging as a valuable, noninvasive, bedside diagnostic tool for objective evaluation of physiologic and hemodynamic parameters related to fluid status, tolerance, and responsiveness. Read More

View Article and Full-Text PDF

Estimation of the plasma volume status of elderly patients with acute decompensated heart failure using bedside clinical, biological, and ultrasound parameters.

Clin Cardiol 2022 Apr 2;45(4):379-385. Epub 2022 Mar 2.

Department of Cardiology, Université Paris-Saclay, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.

Objective: Assessment of intravascular volume status to ensure optimization before hospital discharge could significantly reduce readmissions. It is difficult to evaluate congestion on clinical signs during an episode of acute heart failure (ADHF) in elderly patients.

Hypothesis: There is an association between various volume overload parameters in patients older than 75 years. Read More

View Article and Full-Text PDF

Impact of Right Ventricular-Pulmonary Circulation Coupling on Mortality in SARS-CoV-2 Infection.

J Am Heart Assoc 2022 02 12;11(4):e023220. Epub 2022 Feb 12.

Division of Cardiology Department of Health Sciences University of Milan School of MedicineSan Paolo University HospitalAzienda Socio Sanitaria Territoriale Santi Paolo e Carlo Milan Italy.

Background The COVID-19-related pulmonary effects may negatively impact pulmonary hemodynamics and right ventricular function. We examined the prognostic relevance of right ventricular function and right ventricular-to-pulmonary circulation coupling assessed by bedside echocardiography in patients hospitalized with COVID-19 pneumonia and a large spectrum of disease independently of indices of pneumonia severity and left ventricular function. Methods and Results Consecutive COVID-19 subjects who underwent full cardiac echocardiographic evaluation along with gas analyses and computed tomography scans were included in the study. Read More

View Article and Full-Text PDF
February 2022

Minute Zero: an essential assessment in peri-operative ultrasound for anaesthesia.

Anaesthesiol Intensive Ther 2022 ;54(1):80-84

San Francisco de Asís Hospital, Ultrasonography Unit, Ecographic Diagnostic Center, Madrid, Spain.

In recent years, ultrasonography has gained unmatched importance in medical practice. After the initial use for central vascular access placement and regional anaesthesia, its application has expanded to airway, ocular, abdominal, lung and cardiac ultrasound, with the concept of point of care ultrasound (POCUS) gaining acceptability and applicability in the most diverse situations. In fact, it has recently been acclaimed as the fifth pillar to bedside evaluation [1]. Read More

View Article and Full-Text PDF

Cardiac and vascular point-of-care ultrasound: current situation, problems, and future prospects.

J Med Ultrason (2001) 2022 Jan 8. Epub 2022 Jan 8.

Department of Cardiovascular Medicine, Takamatsu Municipal Hospital, Takamatsu, Japan.

Although clinical application of ultrasound to the heart has a history of about 80 years, its big turning point was the emergence of a portable ultrasound diagnostic machine. As a result, the place, where echocardiography is performed widely spread outside the examination room, and the people who perform echocardiography have also greatly increased. Emergency physicians, anesthesiologists, and primary care physicians became interested in echocardiography and started using it. Read More

View Article and Full-Text PDF
January 2022

Fatal acute lung injury after balloon valvuloplasty in a dog with pulmonary stenosis.

J Vet Cardiol 2022 Feb 24;39:8-13. Epub 2021 Nov 24.

Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2, 10095 Grugliasco, Turin, Italy.

A one-year-old French Bulldog was referred for the management of a severe form of pulmonary valve stenosis (PS) complicated by right-sided congestive heart failure. Echocardiography showed severe valvular PS with right ventricular concentric hypertrophy, dilatation and severe right atrial enlargement. A pulmonary balloon valvuloplasty (PBV) was performed with a balloon-to-pulmonary annulus ratio of 1. Read More

View Article and Full-Text PDF
February 2022

Utility of Lung Ultrasound in the Estimation of Extravascular Lung Water in a Pediatric Population-A Prospective Observational Study.

J Cardiothorac Vasc Anesth 2022 Aug 7;36(8 Pt A):2385-2392. Epub 2021 Nov 7.

Department of Cardiothoracic and Vascular Surgery, PGIMER, Chandigarh, India.

Objective: Lung ultrasound (LUS) is a promising bedside modality for the estimation of extravascular lung water index (EVLWI), but has not been validated against objective measures in children. This study aimed to investigate the correlation of LUS B-line scoring with EVLWI, thresholds indicating elevated EVLWI, and its outcome following pediatric cardiac surgery.

Design: Prospective observational study. Read More

View Article and Full-Text PDF

Point of care venous Doppler ultrasound: Exploring the missing piece of bedside hemodynamic assessment.

World J Crit Care Med 2021 Nov 9;10(6):310-322. Epub 2021 Nov 9.

Division of Nephrology, Medical College of Wisconsin, Wauwatosa, WI 53226, United States.

Accurate assessment of the hemodynamic status is vital for appropriate management of patients with critical illness. As such, there has been a constant quest for reliable and non-invasive bedside tools to assess and monitor circulatory status in order to ensure end-organ perfusion. In the recent past, point of care ultrasonography (POCUS) has emerged as a valuable adjunct to physical examination in various specialties, which basically is a clinician-performed bedside ultrasound to answer focused questions. Read More

View Article and Full-Text PDF
November 2021

[Predictive value of carotid ultrasound in combination with passive leg raising on fluid responsiveness in critically ill patients].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 Sep;33(9):1105-1109

Department of Intensive Care Unit, the First People's Hospital of Fuyang Hangzhou, Hangzhou 311400, Zhejiang, China. Corresponding author: Shao Xuebo, Email:

Objective: To investigate the value of monitor carotid velocity time integral (VTI) and corrected flow time (FTc) by bedside ultrasound before and after passive leg raising (PLR) in predicting fluid responsiveness in critically ill patients.

Methods: A prospective observational study was conducted. Fifty patients with critical illness admitted to the First People's Hospital of Fuyang Hangzhou from January 2020 to March 2021 were enrolled. Read More

View Article and Full-Text PDF
September 2021

Development and evaluation of the focused assessment of sonographic pathologies in the intensive care unit (FASP-ICU) protocol.

Crit Care 2021 Nov 24;25(1):405. Epub 2021 Nov 24.

Department of Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Goettingen, Georg August University, Robert-Koch-Str. 40, 37075, Goettingen, Germany.

Background: The use of ultrasonography in the intensive care unit (ICU) is steadily increasing but is usually restricted to examinations of single organs or organ systems. In this study, we combine the ultrasound approaches the most relevant to ICU to design a whole-body ultrasound (WBU) protocol. Recommendations and training schemes for WBU are sparse and lack conclusive evidence. Read More

View Article and Full-Text PDF
November 2021

Use of pulmonary ultrasound to predict in-hospital mortality in patients with COVID-19 infection.

Gac Med Mex 2021 ;157(3):251-256

Cardiovascular Intensive Care . Instituto Nacional de Cardiología "Ignacio Chávez", Mexico City, Mexico.

Introduction: Lung ultrasound (LUS) implementation in patients with COVID-19 can help to establish the degree of pulmonary involvement, evaluate treatment response and estimate in-hospital outcome.

Objective: To evaluate the application of a LUS protocol in patients with COVID-19 infection to predict in-hospital mortality.

Methods: The study was carried out from April 1 to August 1, 2020 in patients with COVID-19 infection admitted to the Intensive Care Unit. Read More

View Article and Full-Text PDF
October 2021

Left Ventricular Ejection Fraction Assessment by Emergency Physician-Performed Bedside Echocardiography: A Prospective Comparative Evaluation of Multiple Modalities.

J Emerg Med 2021 12 13;61(6):711-719. Epub 2021 Oct 13.

Beaumont Research Institute, Beaumont Hospital, Royal Oak, Michigan.

Background: Although there is some support for visual estimation (VE) as an accurate method to estimate left ventricular ejection fraction (LVEF), it is also scrutinized for its subjectivity. Therefore, more objective assessments, such as fractional shortening (FS) or e-point septal separation (EPSS), may be useful in estimating LVEF among patients in the emergency department (ED).

Objective: Our aim was to compare the real-world accuracy of VE, FS, and EPSS using a sample of point-of-care cardiac ultrasound transthoracic echocardiography (POC-TTE) images acquired by emergency physicians (EPs) with the gold standard of Simpson's method of discs, as measured by comprehensive cardiology-performed echocardiography. Read More

View Article and Full-Text PDF
December 2021

Bronchus-blocked ultrasound-guided percutaneous transthoracic needle biopsy (BUS-PTNB) for intubated patients with severe lung diseases.

Crit Care 2021 10 14;25(1):359. Epub 2021 Oct 14.

Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China.

Background: Examinations based on lung tissue specimen can play a significant role in the diagnosis for critically ill and intubated patients with lung infiltration. However, severe complications including tension pneumothorax and intrabronchial hemorrhage limit the application of needle biopsy.

Methods: A refined needle biopsy technique, named bronchus-blocked ultrasound-guided percutaneous transthoracic needle biopsy (BUS-PTNB), was performed on four intubated patients between August 2020 and April 2021. Read More

View Article and Full-Text PDF
October 2021

Cardiac mass evaluation with cardiac computed tomography: A review.

J Med Imaging Radiat Sci 2021 11 11;52(3S):S78-S87. Epub 2021 Oct 11.

The University of Alabama at Birmingham, Department of Diagnostic Radiology, Birmingham, AL, USA.

Cardiac masses are rare and include both benign and malignant neoplasms as well as pseudo-tumors. The goal of imaging in patients with suspected cardiac mass is to: (1) confirm presence of a mass; (2) determine the mass' location in the heart; (3) characterize the mass to determine if it is benign or malignant; and (4) evaluate its relationship and effect on adjacent structures. Echocardiography is often the first to detect and assess cardiac structures as it is widely available, non-invasive, and can be done bedside. Read More

View Article and Full-Text PDF
November 2021

Takotsubo syndrome as an overlooked and elusive cause of a single episode of dyspnea in young women: a case report.

BMC Cardiovasc Disord 2021 09 10;21(1):430. Epub 2021 Sep 10.

Department of Emergency Medicine, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.

Background: Dyspnea is a common symptom in patients presenting to the emergency department. It has a variety of causes that range from non-urgent to life-threatening. One episode of dyspnea in a healthy young person is easy to overlook. Read More

View Article and Full-Text PDF
September 2021

Bedside echocardiography to predict mortality of COVID-19 patients beyond clinical data: Data from the PROVAR-COVID study.

Rev Soc Bras Med Trop 2021 6;54:e03822021. Epub 2021 Sep 6.

Universidade Federal de Minas Gerais, Centro de Telessaúde do Hospital das Clínicas, Serviço de Cardiologia e Cirurgia Cardiovascular, Belo Horizonte, MG, Brasil.

Introduction: Cardiac involvement seems to impact prognosis of COVID-19, being more frequent in critically ill patients. We aimed to assess the prognostic value of right ventricular (RV) and left ventricular (LV) dysfunction, evaluated by bedside echocardiography (echo), in patients hospitalized with COVID-19.

Methods: Patients admitted in 2 reference hospitals in Brazil from Jul to Sept/2020 with confirmed COVID-19 and moderate/severe presentations underwent clinical and laboratory evaluation, and focused bedside echo (GE Vivid-IQ), at the earliest convenience, with remote interpretation. Read More

View Article and Full-Text PDF
September 2021

Clinical Method Applied to Focused Ultrasound: The Case of Wells' Score and Echocardiography in the Emergency Department: A Systematic Review and a Meta-Analysis.

Medicina (Kaunas) 2021 Jul 28;57(8). Epub 2021 Jul 28.

Internal and Subintensive Medicine Department, Azienda Ospedaliero-Universitaria "Ospedali Riuniti" di Ancona, 60100 Ancona, Italy.

bedside cardiac ultrasound is a widely adopted method in Emergency Departments (ED) for extending physical examination and refining clinical diagnosis. However, in the setting of hemodynamically-stable pulmonary embolism, the diagnostic role of echocardiography is still the subject of debate. In light of its high specificity and low sensitivity, some authors suggest that echocardiographic signs of right ventricle overload could be used to rule-in pulmonary embolism. Read More

View Article and Full-Text PDF

Evaluation of COVID-19-Associated Myocarditis Via Point-of-Care Ultrasound in a Pediatric Patient.

Pediatr Emerg Care 2022 Feb;38(2):94-96

From the Department of Pediatric Emergency Medicine, University of Louisville, Louisville, KY.

Abstract: Coronavirus disease 2019 (COVID-19)-associated myocarditis has been reported from the onset of the pandemic. The presumed etiology is direct damage to the myocardium from severe acute respiratory syndrome coronavirus 2. Common findings include electrocardiogram abnormalities, elevated cardiac markers, and diminished cardiac function. Read More

View Article and Full-Text PDF
February 2022

A practical guide to the lung ultrasound for the assessment of congestive heart failure.

J Echocardiogr 2021 12 16;19(4):195-204. Epub 2021 Jun 16.

Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32, Umeda, Kita-ku, Osaka, 5300001, Japan.

Dyspnea is one of the major symptoms encountered in the emergency department, and lung ultrasound (LUS) is recommended for the rapid diagnosis of the underlying disease. B-lines, the "comet-tail"-like vertical lines moving with respiration, are an ultrasound finding relevant to the pulmonary congestion. They may be observed in the normal lung, but bilateral, ≥ 3 B-lines are considered pathological. Read More

View Article and Full-Text PDF
December 2021

The evolution of cardiac point of care ultrasound for the neonatologist.

Eur J Pediatr 2021 Dec 14;180(12):3565-3575. Epub 2021 Jun 14.

Department of Pediatrics, Division of Neonatology, Children's Hospital of Philadelphia and Perelman School of Medicine, Philadelphia, USA.

Cardiac point of care ultrasound (POCUS) is increasingly being utilized in neonatal intensive care units to provide information in real time to aid clinical decision making. While training programs and scope of practice have been well defined for other specialties, such as adult critical care and emergency medicine, there is a lack of structure for neonatal cardiac POCUS. A more comprehensive and advanced hemodynamic evaluation by a neonatologist has previously published its own clinical guidelines and specific rigorous training programs have been established to achieve competency in neonatal hemodynamics. Read More

View Article and Full-Text PDF
December 2021

Multimodality imaging of the ischemic right ventricle: an overview and proposal of a diagnostic algorithm.

Int J Cardiovasc Imaging 2021 Nov 10;37(11):3343-3354. Epub 2021 Jun 10.

Department of Cardiovascular Diseases, University of Siena, Siena, Italy.

Right ventricular (RV) involvement is frequently detected in patients presenting with acute left ventricular myocardial infarction. The ischemic right ventricle carries a dismal outcome by predisposing the heart to arrhythmic events and mechanical or hemodynamic complications. A comprehensive RV evaluation by multimodality imaging could guide clinical practice but has always been a conundrum for the imagers. Read More

View Article and Full-Text PDF
November 2021

[Application progress of ultrasound monitoring of diaphragm function in clinic].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 May;33(5):638-640

Department of Anesthesiology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei, China.

In recent years, point of care ultrasound (POCUS) has developed rapidly in the fields of anesthesia and critical care. POCUS is widely used in clinic to monitor the function of human tissues and organs such as the heart, lungs, and diaphragm due to its visual, non-invasive, portable, and repeatable characters at the bedside. Diaphragm is an important structure to maintain respiratory function. Read More

View Article and Full-Text PDF

Heart-lung interactions in COVID-19: prognostic impact and usefulness of bedside echocardiography for monitoring of the right ventricle involvement.

Michael Dandel

Heart Fail Rev 2022 Jul 17;27(4):1325-1339. Epub 2021 Apr 17.

German Centre for Heart and Circulatory Research (DZHK) Partner Site, Berlin, Berlin, Germany.

Due to the SARS-CoV-2 infection-related severe pulmonary tissue damages associated with a relative specific widespread thrombotic microangiopathy, the pathophysiologic role of heart-lung interactions becomes crucial for the development and progression of right ventricular (RV) dysfunction. The high resistance in the pulmonary circulation, as a result of small vessel thrombosis and hypoxemia, is the major cause of right heart failure associated with a particularly high mortality in severe COVID-19. Timely identification of patients at high risk for RV failure, optimization of mechanical ventilation to limit its adverse effects on RV preload and afterload, avoidance of medication-related increase in the pulmonary vascular resistance, and the use of extracorporeal membrane oxygenation in refractory respiratory failure with hemodynamic instability, before RV failure develops, can improve patient survival. Read More

View Article and Full-Text PDF

Operating bedside cardiac ultrasound program in emergency medicine residency: A retrospective observation study from the perspective of performance improvement.

PLoS One 2021 2;16(4):e0248710. Epub 2021 Apr 2.

Department of Emergency Medicine, Seoul National University Hospital, Seoul, South Korea.

Background: Point-of-care ultrasound is one of useful diagnostic tools in emergency medicine practice and considerably depends on physician's performance. This study was performed to evaluate performance improvements and favorable attitudes through structured cardiac ultrasound program for emergency medicine residents.

Methods: Retrospective observational study using the point-of-care ultrasound (PoCUS) database in one tertiary academic-teaching hospital emergency department has been conducted. Read More

View Article and Full-Text PDF
September 2021

COVUS: An Algorithm to Maximize the Use of Point-of-Care Ultrasound in the Emergency Management of COVID-19.

J Emerg Med 2021 07 9;61(1):61-66. Epub 2021 Feb 9.

Department of Emergency Medicine, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York.

Background: Patients with coronavirus disease 2019 (COVID-19) present with diagnostic challenges because COVID-19 can cause varied end-organ failures that mimic respiratory distress of pulmonary origin. Early identification of concurrent complications can significantly alter patient management and course. Point-of-care ultrasound (POCUS) can be particularly useful in helping to differentiate concomitant complications with COVID-19. Read More

View Article and Full-Text PDF

What are the echocardiographic findings of acute right ventricular strain that suggest pulmonary embolism?

Anaesth Crit Care Pain Med 2021 04 26;40(2):100852. Epub 2021 Mar 26.

Department of Emergency Medicine, Rush University Medical Center, 1750 W. Harrison Street, Kellogg Suite 108, Chicago, IL 60612, USA.

Introduction: Pulmonary embolism (PE) is a potentially fatal disease encountered in the hospital setting. Prompt diagnosis and management can improve outcomes and survival. Unfortunately, a PE may be difficult to diagnose in a timely manner. Read More

View Article and Full-Text PDF