title: [Hand-held echocardiographic devices: what do they add to the initial cardiovascular evaluation?].
abstract: OBJECTIVE
  Hand-held echocardiographic devices have recently become available. Our objective was to determine, on the basis of clinical data and basic diagnostic techniques, whether hand-held devices offer additional information useful not provided by the initial cardiovascular diagnosis.
  
  
  METHODS
  We prospectively studied the presence and severity (absent, mild, significative) of 7 frequent heart diseases (aortic or mitral stenosis-regurgitation, tricuspid regurgitation, and left ventricular systolic dysfunction-hypertrophy) in 36 consecutive patients (50% men; mean age 68 12 years) with 3 different methods: clinical examination and basic complementary exams, hand-held echocardiography with 2D and color Doppler imaging (OptiGo, Philips Medical Systems, The Netherlands) and a standard, last-generation transthoracic echocardiogram (Sonos 550, Philips Medical Systems, The Netherlands). We compared the results obtained with the first two methods, and combined the results of both to compare these findings against the results obtained with standard electrocardiography. Percentage agreement and Somer's D, a measure of association between ordinal variables, were calculated.
  
  
  RESULTS
  The hand-held device obtained better results than clinical examination (agreement 87 vs. 65%; D = 0.79 0.04 vs. 0.19 0.53) and identified severe lesions that were classified incorrectly by clinical examination in 39% (14/36) patients. However, in 8 patients (10 evaluations) it misclassified severe lesions.
  
  
  CONCLUSIONS
  In experienced hands, a hand-held echocardiographic device offers additional information not obtained from an initial cardiovascular diagnosis for common cardiovascular disorders, but it is no substitute for complete echocardiographic examination.
authors: Servicio de Cardiología. Hospital Universitario de Getafe. Getafe. Madrid. Spain.
authors: Arturo
authors: A
authors: Martín-Peñato
authors: José L
authors: JL
authors: Zamorano
authors: Carlos
authors: C
authors: Almería
authors: José L
authors: JL
authors: Rodrigo
authors: Cecilia
authors: C
authors: Corros
authors: María
authors: M
authors: Luaces
authors: Antonio
authors: A
authors: Conde
authors: Isidro
authors: I
authors: Vilacosta
authors: Carlos
authors: C
authors: Macaya
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D018618:Echocardiography, Doppler, Color / Q000295:instrumentation* / Q000379:methods; D004864:Equipment and Supplies; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male