scholarly journals A Case Report of Acute Heart Failure Due to Infective Aortic Endocarditis Diagnosed by Point-of-care Ultrasound

2020 ◽  
Vol 4 (2) ◽  
pp. 193-196
Author(s):  
Ryan Gallagher ◽  
Michelle Wilson ◽  
Pamela Hite ◽  
Bradley Jackson
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Aortic Valve ◽  
Acute Heart Failure ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Complication Rates ◽  
Threatening Condition ◽  
Valve Insufficiency ◽  
Life Threatening

Introduction: Infective endocarditis (IE) is a life-threatening condition with significant morbidity and mortality, and can require surgical repair. Case Report: A 36-year-old man presented to the emergency department for worsening dyspnea and chest pain. Point-of-care echocardiography demonstrated a mobile oscillating mass on the aortic valve with poor approximation of the valve leaflets, suggesting aortic valve insufficiency secondary to IE as the cause of acute heart failure. The patient underwent emergent aortic valve replacement within 24 hours. Discussion: While point-of-care echocardiography has been well documented in identifying tricuspid vegetations, aortic valve involvement and subsequent heart failure is less well described. Earlier recognition of aortic valve vegetations and insufficiency can expedite surgical intervention, with decreased complication rates linked to earlier antimicrobial therapy. Conclusion: This case report highlights the ability of point-of-care ultrasound to identify aortic vegetations, allowing for the earlier diagnosis and therapy.

scholarly journals Point-of-care Echocardiogram as the Key to Rapid Diagnosis of a Unique Presentation of Dyspnea: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 424-427
Author(s):  
Michael Moore ◽  
Brian Dilcher ◽  
Joseph MInardi ◽  
Kimberly Quedado ◽  
Erica Shaver
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Respiratory Symptoms ◽  
Point Of Care ◽  
Diagnostic Error ◽  
Left Ventricular ◽  
Rapid Diagnosis ◽  
Point Of Care Ultrasound ◽  
Emergency Physicians ◽  
Ventricular Thrombus

Introduction: Dyspnea is commonly evaluated in the emergency department (ED).The differential diagnosis is broad. Due to the large volume of dyspneic patients evaluated, emergency physicians (EP) will encounter uncommon diagnoses. Early, liberal application of point-of-care ultrasound (POCUS) may decrease diagnostic error and improve care for these patients. Case Report: We report a 48-year-old male presenting to the ED with cough and progressively worsening dyspnea for 11 months after multiple healthcare visits. Using POCUS, the EP was immediately able to diagnose a severe dilated cardiomyopathy (DCM) with left ventricular thrombus. Conclusion: Given that non-ischemic DCM is one of the most common etiologies of heart failure, often presenting with respiratory symptoms, POCUS is key to rapid diagnosis and, along with modalities such as electrocardiography and chest radiograph, should be standard practice in the workup of dyspnea, regardless of age or comorbidities.

scholarly journals BrucellaEndocarditis as a Late Onset Complication of Brucellosis

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Panagiotis Andriopoulos ◽  
Christos Antoniou ◽  
Panagiota Manolakou ◽  
Athanassios Vasilopoulos ◽  
George Assimakopoulos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Case Report ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Antibiotic Treatment ◽  
Late Onset ◽  
Life Threatening ◽  
Life Threatening Complication

Brucellaendocarditis (BE) is a rare but life threatening complication ofbrucellosis. We present a case report of a patient with relapsing brucellosis complicated with aortic valve endocarditis. The patient underwent valve replacement and required prolonged antibiotic treatment because of rupture of the noncoronary leaflet and development of congestive heart failure. Since the onset of endocarditis in patients with brucellosis is not known, proper follow-up is required in order to identify any late onset complications, especially in endemic areas.

scholarly journals The Double Gut Point: A Novel Sonographic Sign of Pneumoperitoneum

2022 ◽  
Author(s):  
Yale Tung Chen ◽  
Tomas Villén Villegas ◽  
Elmo Pereira
Keyword(s):  
Point Of Care ◽  
Critically Ill Patient ◽  
Point Of Care Ultrasound ◽  
Sudden Increase ◽  
Urgent Surgery ◽  
Free Air ◽  
Linear Probe ◽  
Threatening Condition ◽  
Life Threatening ◽  
Upper Abdominal

Abstract Pneumoperitoneum is a life-threatening condition, caused by hollow organ perforation. The diagnosis is often difficult, and Point-of-care ultrasound can be useful to distinguish from different conditions, and early set the indication of urgent surgery. We report a critically ill patient presented to the Emergency Department with sudden increase in upper abdominal pain and distension with a diagnosis of small bowel obstruction on ultrasound using a curvilinear probe. After repeating the ultrasound using a linear probe, two dynamic points at mesogastrium very similar to the “double lung point” seen in thoracic ultrasound was detected. This “double gut point” due to bowel ischemia and perforation was confirmed on a computed tomography scan. In this case, the finding of an abdominal “double gut point” allowed us to diagnose pneumoperitoneum, being a novel sign not previously described, that could aid to diagnose small amounts of free air in the peritoneal cavity.

scholarly journals Ruptured Ectopic Pregnancy with an Intrauterine Device: Case Report and Sonographic Considerations

2020 ◽  
Vol 4 (4) ◽  
pp. 559-563
Author(s):  
Derick Jones ◽  
Tobias Kummer ◽  
Jessica Schoen
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Rare Case ◽  
Point Of Care ◽  
Intrauterine Device ◽  
Point Of Care Ultrasound ◽  
High Morbidity ◽  
Extrauterine Pregnancy ◽  
Life Threatening ◽  
High Degree

Introduction: Ectopic pregnancy carries a high morbidity and mortality; patients are at risk for rupture and life-threatening hemorrhage. Case Report: We present a rare case of ruptured abdominal ectopic pregnancy in a patient with a well-positioned intrauterine device (IUD) and discuss the diagnostic utility that transabdominal point-of-care ultrasound (POCUS) can have when performed at the bedside. Conclusion: While pregnancy with an IUD in place is rare, when it is encountered the emergency provider should maintain a high degree of suspicion for extrauterine pregnancy and perform prompt evaluation for hemorrhagic shock using diagnostic POCUS.

scholarly journals Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 124
Author(s):  
Marta Torres-Arrese ◽  
Gonzalo García de Casasola-Sánchez ◽  
Manuel Méndez-Bailón ◽  
Esther Montero-Hernández ◽  
Marta Cobo-Marcos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Point Of Care ◽  
Femoral Vein ◽  
Common Disease ◽  
Point Of Care Ultrasound ◽  
High Morbidity ◽  
Major Health Problem ◽  
Study Results ◽  
The Impact

Background and Objectives: Acute heart failure (AHF) is a common disease and a cause of high morbidity and mortality, constituting a major health problem. The main purpose of this study was to determine the impact of multiorgan ultrasound in identifying pulmonary hypertension (PH), a major prognostic factor in patients admitted due to AHF, and assess whether there are significant changes in the venous excess ultrasonography (VE × US) score or femoral vein Doppler at discharge. Materials and Methods: Patients were evaluated with a standard protocol of lung ultrasound, echocardiography, inferior vena cava (IVC) and hepatic, portal, intra-renal and femoral vein Doppler flow patterns at admission and on the day of discharge. Results: Thirty patients were enrolled during November 2021. The mean age was seventy-nine years (Standard Deviation–SD 13.4). Seven patients (23.3%) had a worsening renal function during hospitalization. Regarding ultrasound findings, VE × US score was calculated at admission and at discharge, unexpectedly remaining unchanged or even worsened (21 patients, 70.0%). The area under the curve for the lung score was 83.9% (p = 0.008), obtaining a cutoff value of 10 that showed a sensitivity of 82.6% and a specificity of 71.4% in the identification of intermediate and high PH. It was possible to monitor significant changes between both exams on the lung score (16.5 vs. 9.3; p < 0.001), improvement in the hepatic vein Doppler pattern (2.4 vs. 2.1; p = 0.002), improvement in portal vein Doppler pattern (1.7 vs. 1.4; p = 0.023), without significant changes in the intra-renal vein Doppler pattern (1.70 vs. 1.57; p = 0.293), VE × US score (1.3 vs. 1.1; p = 0.501), femoral vein Doppler pattern (2.4 vs. 2.1; p = 0.161) and IVC collapsibility (2.0 vs. 2.1; p = 0.420). Conclusions: Our study results suggest that performing serial multiorgan Point-of-Care ultrasound can help us to better identify high and intermediate probability of PH patients with AHF. Currently proposed multi-organ, venous Doppler scanning protocols, such as the VE × US score, should be further studied before expanding its use in AHF patients.

scholarly journals Usefulness of Serial Multiorgan Point-of-Care Ultrasound in Acute Heart Failure: Results from a Prospective Observational Cohort

2021 ◽  
Author(s):  
Marta Torres-Arrese ◽  
Gonzalo García de Casasola-Sánchez ◽  
Manuel Méndez-Bailón ◽  
Esther Montero-Hernández ◽  
Marta Cobo-Marcos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Point Of Care ◽  
Vena Cava ◽  
Common Disease ◽  
Point Of Care Ultrasound ◽  
High Morbidity ◽  
Major Health Problem ◽  
Study Results ◽  
The Impact

Background and Objectives: Acute Heart Failure (AHF) is a common disease and a cause of high morbidity and mortality, constituting a major health problem. The main purpose of this study was to determine the impact of multiorgan ultrasound in identifying the pulmonary hypertension (PH) in patients admitted due to AHF, predict the evolution of the disease during hospitalization and identify areas of improvement in the care of patients with AHF. Materials and Methods: Patients were evaluated with a standard exam of lung ultrasound, echocardiography, inferior vena cava (IVC) and femoral, renal, hepatic, portal venous Doppler flow patterns at admission and on the day of discharge. Results: Thirty patients were enrolled during November 2021. The mean age was seventy-nine years (Standard Deviation &ndash; SD 13,4). Seven patients (23.3%) had a renal function worsening. Regarding ultrasound findings, venous excess ultrasonography score (VExUS) score was calculated at admission and at discharge, surprisingly remaining unchanged or even worsened in most of them (21 patients, 70.0%). The area under the curve for the Lung Score was 83.9% (p = 0.008), obtaining a cutoff value of 10 that showed a sensitivity of 82.6% and a specificity of 71.4% in the identification of intermediate and high PH. It was possible to monitor significant changes between both exams on the lung score (p &amp;lt;0.001), hepatic vein Doppler (p &amp;lt;0.001), portal vein Doppler (p = 0.030), intra-renal vein Doppler (p = 0.025) and VExUS score (p = 0.023), remaining similar the femoral vein Doppler (p = 0.177) and IVC (p = 0.132). Conclusions: Our study results suggest that performing serial multiorgan Point-of-Care ultrasound can help us to better identify high and intermediate probability of PH patients with AHF. Currently proposed multi-organ, venous Doppler scanning protocols, such as the VExUS score, should be further studied in different populations before expanding its use in AHF patients.

Acute heart failure: treatment

ESC CardioMed ◽  
2018 ◽  
pp. 1921-1926
Author(s):  
Dimitrios Farmakis ◽  
John Parissis ◽  
Gerasimos Filippatos
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Outpatient Care ◽  
Management Plan ◽  
Second Phase ◽  
Oral Medications ◽  
Third Phase ◽  
Threatening Condition ◽  
Life Threatening ◽  
Disease Modifying

Acute heart failure (AHF) is a potentially life-threatening condition that requires rapid evaluation and treatment and usually results in hospitalization of the patient. The in-hospital management of AHF may be divided into three phases: a first phase of acute care, a second phase of stabilization, and a third phase of discharge. In the first phase, the main goals are the rapid management of life-threatening conditions; the effective resolution of congestion and/or peripheral hypoperfusion with stabilization of patient haemodynamics; and protection of vital organ function. In the second phase, the main goals are the transition from intravenous to oral medications; the initiation, reinstitution, or titration of disease-modifying medications; any further cardiac assessments and treatments; and the identification and management of co-morbid conditions. Finally, the third phase includes the assessment of the readiness for discharge; the development of a chronic disease management plan; and the transition to outpatient care.

scholarly journals Point-of-care Ultrasound in Early Diagnosis of Cardiomyopathy in a Child with Viral Myocarditis: A Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 186-189
Author(s):  
Ayush Gupta ◽  
Trevor Eckenswiller
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Cardiogenic Shock ◽  
Point Of Care ◽  
Viral Myocarditis ◽  
Pediatric Emergency ◽  
Point Of Care Ultrasound ◽  
High Morbidity ◽  
Threatening Condition ◽  
High Index Of Suspicion

Introduction: Pediatric myocarditis is a commonly missed diagnosis in the pediatric emergency department (ED) with high morbidity and mortality. The presentation of cardiogenic shock secondary to myocarditis and septic shock can be difficult to differentiate during initial resuscitation, and incorrect treatment can lead to poor prognosis. Early diagnosis may provide a better prognosis for this life-threatening condition. Case Report: We report a case of a five-year-old female who presented to the ED with non-specific symptoms of myocarditis. Rapid point-of-care ultrasound led to early diagnosis, correct management, and great prognosis for the patient. Conclusion: Providers must maintain a high index of suspicion for cardiogenic shock in patients with nonspecific symptoms and fluid unresponsiveness. Point-of-care ultrasound can help in the identification of cardiac disorders and guide practitioners in their management plans.

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