title: Usefulness of a new miniaturized echocardiographic system in outpatient cardiology consultations as an extension of physical examination.
abstract: BACKGROUND
  The aim of this study was to assess the usefulness of a new miniaturized echocardiographic system (MS) to perform bedside echocardiography in initial outpatient cardiology consultations, in addition to physical examination.
  
  
  METHODS
  One hundred eighty-nine patients referred for initial cardiology outpatient consultations at two tertiary hospitals in two countries were studied. Each patient was submitted to physical examination followed by MS assessment. Scanning time, the number of examinations with abnormal results after physical examination and the MS, and the information obtained by physical examination alone and followed by the MS (in terms of its importance in reaching a diagnosis, in the necessity of performing routine echocardiography, and in the decision to release the patient from the outpatient clinic) were assessed.
  
  
  RESULTS
  The scanning time with the MS was 180 ± 86 seconds. Its use after physical examination led to diagnoses in 141 patients (74.6%) and to an additional 37 patients (19.6%) being released from the outpatient clinic. After physical examination followed by MS assessment, only 64 patients (33.9%) were sent to the echocardiography lab. The MS modified the decision of whether to send a patient to the echocardiography lab, with referral determined by the MS in 27 patients (14.3%) and no referral determined by the MS in 58 patients (30.7%).
  
  
  CONCLUSIONS
  The new MS caused a negligible increase in the duration of consultations. It showed additive clinical value over physical examination, increasing the number of diagnoses, reducing the use of unnecessary routine echocardiography, increasing the number of adequate echocardiographic studies, and determining a large number of releases from the outpatient clinic.
authors.affiliation: Hospital da Luz, Cardiology Department, Lisbon, Portugal. ncardim@hospitaldaluz.pt
authors.forename: Nuno
authors.initials: N
authors.lastname: Cardim
authors.forename: Covadonga
authors.initials: C
authors.lastname: Fernandez Golfin
authors.forename: Daniel
authors.initials: D
authors.lastname: Ferreira
authors.forename: Adalia
authors.initials: A
authors.lastname: Aubele
authors.forename: Julia
authors.initials: J
authors.lastname: Toste
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Cobos
authors.forename: Vanda
authors.initials: V
authors.lastname: Carmelo
authors.forename: Igor
authors.initials: I
authors.lastname: Nunes
authors.forename: António Gouveia
authors.initials: AG
authors.lastname: Oliveira
authors.forename: Jose
authors.initials: J
authors.lastname: Zamorano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data*; D004452:Echocardiography / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D010808:Physical Examination / Q000706:statistics & numerical data*; D011174:Portugal / Q000453:epidemiology; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013030:Spain / Q000453:epidemiology; D055815:Young Adult