Focused cardiac ultrasound to expedite diagnosis of pulmonary hypertension in children in the emergency department

2020 ◽  
Vol 38 (3) ◽  
pp. 629-637
Author(s):  
Almaz Dessie ◽  
Stephanie Leung ◽  
Beth D'Amico ◽  
Kayleigh A. Fischer ◽  
Zachary Binder ◽  
...  
2020 ◽  
Vol 76 (4) ◽  
pp. S153
Author(s):  
J.R. Balderston ◽  
A. You ◽  
D.P. Evans ◽  
L. Taylor ◽  
J. Joyce ◽  
...  

2020 ◽  
Vol 39 (11) ◽  
pp. 2211-2217
Author(s):  
Jessica R. Balderston ◽  
Michael E. Sternberg ◽  
J. Michael Joyce ◽  
David P. Evans ◽  
Zachary M. Gertz

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jessica R. Balderston ◽  
Alan X. You ◽  
David P. Evans ◽  
Lindsay A. Taylor ◽  
Zachary M. Gertz

Abstract Background Focused cardiac ultrasound (FOCUS) can aid in evaluation and management of patients with cardiac arrest, but image quality in this population has been questioned. Our goal was to determine how often adequate imaging can be obtained in cardiac arrest patients. Methods We conducted a prospective cohort study to examine the utility of FOCUS in cardiac arrest. All patients who presented to the Emergency Department (ED) in cardiac arrest or who had cardiac arrest while in the ED over 6 months were prospectively identified. FOCUS images were obtained as part of routine clinical care. Patients with images obtained were paired with age- and gender-matched controls who underwent FOCUS for another indication during the study period. Image quality was scored by two blinded reviewers using a 0–4 scale, with a score of ≥ 2 considered adequate. Results There were 137 consecutive cardiac arrests, 121 out-of-hospital and 16 in-hospital, during the study period. FOCUS images were recorded in 126 (92%), who were included in the analysis. The average age was 58 years, and 45% were female. Ninety-seven studies (77%) were obtained during advanced cardiac life support while 29 (23%) were obtained after return of spontaneous circulation. The controls were appropriately matched. Of the cardiac arrest studies, 106 (84%) were rated adequate, compared to 116 (92%) in controls (p = 0.08). When compared to control FOCUS studies, the scores given to studies of cardiac arrest patients were lower (p = 0.001). Conclusions FOCUS can reliably be used during cardiac arrest to obtain images adequate to answer clinical questions and guide therapies.


2018 ◽  
Vol 25 (5) ◽  
pp. 293-297
Author(s):  
Azlan Helmy Abd Samat ◽  
Hashim Embong

Introduction: Ortner’s syndrome is a rare condition, known as cardiovocal condition as patients present with hoarseness of voice due to cardiovascular causes. Case presentation: We present a case of Ortner’s syndrome secondary to leaking thoracic aortic aneurysm in a patient who came to emergency department with hypotension and hoarseness of voice for 3 months. Focused cardiac ultrasound (FOCUS) and rapid ultrasound in shock (RUSH) were performed which revealed a thoracic aortic arch aneurysm. Discussion: Focused cardiac ultrasound and rapid ultrasound in shock examination in the emergency department had expedited the diagnosis of this rare condition, hence the subsequent definitive investigation and management. Conclusion: This case highlights the need for high index of suspicion for thoracic aneurysm in patients with unexplained cardiovocal symptoms. It also highlights the importance of point-of-care ultrasound in the emergency department and the significance of utilizing the suprasternal view to look for pathology at the arch of aorta.


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