[Detection of left cardiopathy using echocardiography during acute respiratory failure in chronic respiratory insufficiency].
Echocardiography was performed in a systematic fashion in 58 patients suffering from on-chronic respiratory failure (IRC) who were admitted to the intensive care unit. The prevalence of left ventricular disease in patients with IRC who were admitted to the intensive care unit was 31%, there were 18 cases of cardiac disease: nine had hypertrophic cardiac disease (two with intraventricular gradients), three had dilated cardiomyopathies, and there were six cases of ischaemic cardiac disease. Among these cases, six had not previously been diagnosed as having cardiac disease (10%). In cases with poor echogenicity by the transthoracic root, oesophageal echocardiography was performed and this improved the feasibility of a good examination with only a five per cent failure rate. Left ventricular disease was implicated in the clinical assessment eleven times (19%), either on admission (nine times) or during the course of the in-patient treatment (twice). In directing the initial assessment and the aetiological treatment, echocardiography directly contributed to better management in six cases (10%). As regards the number of cases of cardiac disease which were detected, the study confirms the value of this technique at the bedside of the patient. The use of the transoesophageal route improves the diagnostic value including those patients who were intubated and ventilated.
Gouello
J P
JP
Service de Réanimation médicale, CHU, Angers.
Bouachour
G
G
Vincent
J F
JF
Asfar
P
P
Roy
P M
PM
Alquier
P
P
D000208:Acute Disease; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D002908:Chronic Disease; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D015995:Prevalence; D011446:Prospective Studies; D011656:Pulmonary Emphysema / Q000150:complications; D012131:Respiratory Insufficiency / Q000150:complications*; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy
Dépistage des cardiopathies gauches par échocardiographie au cours de l'insuffisance respiratoire aiguë des insuffisances respiratoires chroniques.