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European Journal of Echocardiography 2005 6(3):196-201; doi:10.1016/j.euje.2004.09.013
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Copyright © 2004, The European Society of Cardiology

Impact of hand-carried cardiac ultrasound on diagnosis and management during cardiac consultation rounds

Lotte E de Groot-de Laat, Folkert J. ten Cate*, Eleni C Vourvouri, Ron T van Domburg and Jos R.T.C Roelandt

Department of Cardiology, Thoraxcenter, Ba 304, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands

Received 8 December 2003; received in revised form 9 September 2004; accepted after revision 15 September 2004.

* Corresponding author. Tel.: +31 10 4633533; fax: +31 10 4635498. E-mail: f.j.tencate@erasmusmc.nl


  Abstract

Aim To evaluate the impact of hand-carried cardiac ultrasound (HCU) on the diagnosis and management of patients during cardiac consultation rounds.

Methods and results One hundred and fifty patients hospitalized in non-cardiac units were included after the consulting cardiologist felt that an echocardiographic examination was indicated as part of his work-up. They were randomly allocated to echocardiography with an HCU device (SonoHeartTM, SonoSite, Inc.) (75 patients) or with a full-featured standard echo (FE) system (75 patients). The consulting cardiologist noted whether a definitive diagnosis was made or further study was necessary. Diagnosis and change in management were noted. In the HCU patient group there were 103 clinical questions. Seventy-two percent of the referral questions required no comprehensive echocardiographic evaluation. For questions of left ventricular function, valve abnormalities and pericardial effusion this was 98%. In 48% there was an immediate change in clinical management. In the FE patient group there were 94 clinical questions. In 32% the FE examination led to change in clinical management.

Conclusion HCU echocardiography provides clinically worthwhile assessment of left ventricular function, valve abnormalities and pericardial effusion in 98% of the cases. A direct assessment of cardiac function and anatomy at the bedside by an experienced cardiologist results in a significant immediate change in clinical management during consultation.

Keywords: Hand-carried ultrasound device; Consultation rounds; Management


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