Evaluation of diagnostic efficiency of bedside cardiac ultrasonography performed by emergency specialist.

Abstract

In emergency medicine, ultrasound is frequently used in the diagnostic and therapeutic procedures and evaluation of treatment of critically ill patients simultaneously, due to its bedside applicability, rapidness and inexpensive cost. The competence of emergency physician in focused cardiac ultrasound evaluations and the success of diagnosing cardiac diseases were evaluated in a patient group presenting to the emergency department with complaints of non-traumatic chest pain and shortness of breath. We included patients with complaints of chest pain and shortness of breath and underwent cardiac ultrasound performed by emergency physician. Then, patients were evaluated by a cardiologist. The diagnoses made by the emergency physician were compared with the diagnoses made by the cardiologist. A total of 303 patients were included. The diagnoses made by the emergency medicine specialist and cardiologist as a result of the evaluation were recorded as 56.7% vs 52.10% for acute coronary syndrome, 29.70% vs 31.60% for congestive heart failure, 3.6% vs 3.30% for pulmonary embolism, 2.1% vs 2.10% for hypertensive pulmonary edema, 1.9% vs 2.10% for pericarditis, and 0.60% vs 1.30% for aortic dissection. It was determined that focused cardiac ultrasound performed by emergency physician was sufficient in terms of accuracy of findings and diagnosis, and played an important role in excluding or including fatal diagnoses and conditions. The success rates of emergency physician can be further increased with long-term and comprehensive training programs.