Dr KK Aggarwal
New Delhi, November 22, 2019 :
Is a point-of-care, qualitative or semi-quantitative means of assessing cardiac size, structure, and function that is performed and interpreted by the doctor at the same time that the physical examination is conducted.
Multiple studies conducted in inpatient and outpatient settings have shown that focused echocardiography is more reliable and accurate than physical examination for the diagnosis of left ventricular systolic dysfunction.
Focused echocardiography is indicated in outpatient and inpatient settings for screening and diagnostic purposes. Diagnostic indications include acute critical cardiopulmonary conditions such as dyspnea, chest pain, trauma, arterial hypotension, shock, respiratory failure, and cardiac arrest. Focused echocardiography should not replace physical examination or more advanced, comprehensive diagnostic measures such as formal echocardiography.
Focused echocardiography is more effective than physical examination for the identification of left ventricular systolic dysfunction, with a sensitivity of 73 to 100% and a specificity of 64 to 96%. When performed by trained emergency medicine and critical care physicians, focused echocardiography correlates well with quantitative assessment of left ventricular systolic function (e.g., Simpson’s method and assessment of left ventricular fractional shortening) when performed by echocardiographers.
Focused cardiac ultrasonography is indicated in both outpatient and inpatient settings in persons with risk factors for atherosclerotic cardiovascular disease (e.g., advanced age, high blood pressure, dyslipidemia, diabetes mellitus, and tobacco smoking), an abnormal electrocardiogram, or elevated levels of brain natriuretic peptides. [NEJM]