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Limited bedside echocardiography by emergency physicians for diagnosis of diastolic heart failure
2012
IntroductionThe identification of diastolic heart failure (DHF) is important for determining the prognosis of congestive heart failure patients. This study attempted to determine the accuracy of emergency physicians who performed bedside echocardiography (BECH) in patients with diastolic dysfunction.MethodsThree attending emergency physicians underwent 3 h of didactic and 3 h of hands-on training taught by a cardiology specialist for the echocardiographic diagnostic criteria of DHF. Between February and April 2010, the emergency physicians performed BECH for patients presenting with dyspnoea, and echocardiographic views were recorded. Our gold standard for the diagnosis of diastolic dysfunction was the cardiologists' echocardiography report. Results were compared with χ2 testing.ResultsOf the 69 enrolled patients, 51 were diagnosed as having diastolic dysfunction by emergency physicians. The sensitivity of BECH was 89% (77–95) and specificity was 80% (51–95) with 95% CI. The accuracy of the emergency physicians' echocardiographic diagnosis was 87%.ConclusionBECH performed by emergency physicians may serve as an objective, rapid, non-invasive tool in the assessment of patients presenting with dyspnoea in ED.
Journal Article