The role of urgent transthoracic echocardiography in the evaluation of patients presenting with acute chest pain.
Chest pain is one of the most frequent reasons for presentation to the Emergency Department. The possible causes of chest pain are numerous and diverse, but importantly, several conditions, such as acute coronary syndrome, pulmonary embolism and aortic dissection, require urgent management and, in some cases, may be life-threatening. In such situations, a prompt and accurate diagnosis is vital. Two-dimensional echocardiography is a safe, painless and rapid test that can be performed in the Emergency Department and ensure a correct diagnosis as well as identify other complications and help institute appropriate management strategies swiftly. We review the current indications for urgent echocardiography in this article, with reference to international management guidelines where available, when managing patients with suspected acute coronary syndrome, acute pulmonary embolism, acute aortic dissection, acute pericarditis and trauma. We also discuss the differences between comprehensive and FOcussed Cardiac UltraSound (FOCUS) echocardiography studies, along with the associated quality control and medicolegal implications.
Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, UK. benoy@doctors.org.uk
Benoy Nalin
BN
Shah
Shahram
S
Ahmadvazir
Jatinder Singh
JS
Pabla
Kostas
K
Zacharias
Roxy
R
Senior
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging; D000208:Acute Disease; D000553:Ambulatory Care / Q000379:methods*; D001018:Aortic Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D002637:Chest Pain / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D004452:Echocardiography; D006801:Humans; D010493:Pericarditis / Q000175:diagnosis / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000000981:diagnostic imaging; D013997:Time Factors; D014218:Triage