title: Validity of a 5-minute focused echocardiography with A-F mnemonic performed by non-echocardiographers in the management of patients with acute chest pain.
abstract: OBJECTIVE
  To validate the practicality of focused echocardiography with A-F mnemonic performed by non-specialists in patients with suspected acute coronary syndrome (ACS).
  
  
  METHODS
  This prospective observational study was conducted in the Emergency Room within 12 months period. Study population consisted of consecutive patients with preliminary diagnosis of an ACS. The following data were analyzed: demographics, clinical condition, medical history, ECG, transthoracic echocardiography (TTE) and levels of cardiac necrotic markers. TTE was performed within the first 15 minutes after the admission by the resident on-call. TTE images were interpreted and reported with mnemonic A-F. All studies were recorded and reviewed within 24 hours by the cardiologist.
  
  
  RESULTS
  1312 consecutive patients were enrolled to the study. TTE with A-F mnemonic revealed: RWMAs in 82.87% patients with confirmed ACS, other significant cardiac pathologies were found in 2.21% in ACS and 46.52% in non-ACS groups respectively. On the basis of these findings, 20 (1.92%) ACS and 29 (10.62%) non-ACS group patients underwent target operative treatment. Survey showed that both echocardiographic image acquisition and its interpretation with A-F mnemonic, took less than 5 minutes in 95% of cases. Residents found A-F mnemonic algorithm simple and useful. No differences were found in key findings between TTE performed by resident and the cardiologist.
  
  
  CONCLUSIONS
  Focused echocardiography with A-F mnemonic allows both confirmation of acute myocardial ischemia and detection of the other life-threatening cardiac conditions resulting in proper bedside decision of directed treatment. Mnemonic based TTE enables reliable examination by properly trained residents.
authors.affiliation: The Department of Interventional Cardiology, John Paul 2nd Hospital, Pradnicka 80, 31 202, Cracow, Poland. dorotasobczyk@yahoo.com.
authors.forename: Dorota
authors.initials: D
authors.lastname: Sobczyk
authors.affiliation: The Department of Interventional Cardiology, John Paul 2nd Hospital, Pradnicka 80, 31 202, Cracow, Poland. krzysztofnycz@yahoo.com.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Nycz
authors.affiliation: 2nd Clinic of Anaesthesiology and Intensive Care, Warsaw Medical University, Warszawa, Poland. pawel_andruszkiewicz@cyberia.pl.
authors.forename: Pawel
authors.initials: P
authors.lastname: Andruszkiewicz
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002637:Chest Pain / Q000175:diagnosis*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011361:Professional Competence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult