title: Effect of Breast Sling Use on Transthoracic Echocardiographic Examination Time and Image Quality in Women with Large Breasts.
abstract: BACKGROUND
  Transthoracic echocardiographic examinations in women with large breasts are technically demanding and can lead to suboptimal image quality, excessive scan time, and cause pain and discomfort to patients.
  
  
  OBJECTIVE
  Evaluate the effects of self-made breast sling used during transthoracic echocardiographic examination on scanning time, image quality, pain, and satisfaction in women with large breasts.
  
  
  METHODS
  A self-made breast sling was developed by the study team and tested in 26 women with bra cup size of C or larger, who were scheduled for transthoracic echocardiography. Each patient underwent transthoracic echocardiographic examination twice, with and without breast sling use. The sequence of the examinations was determined at random. The primary outcome was scan time in apical views. Secondary outcomes included total scan time, image quality in apical views (qualitative scores), patients' and sonographers' pain (qualitative scores), and patients' satisfaction (qualitative scores). Outcomes were compared within individual subjects.
  
  
  RESULTS
  The use of self-made breast sling did not reduce scan time in apical views (mean difference 2.8 minutes, p = 0.053), but it reduced total scan time (mean difference 5.9 minutes, p = 0.04). Breast sling use was not associated with improvement in image quality scores (p = 0.59), patients' pain (p = 0.21), and sonographers' shoulder-back-neck pain (p = 0.052). It improved patients' satisfaction (p = 0.01) and sonographers' wrist pain (p = 0.035).
  
  
  CONCLUSIONS
  In women with large breasts who required transthoracic echocardiographic examination, the use of self-made breast sling did not improve scan time and image quality in apical views. It may improve total scan time, patients' satisfaction, and sonographers' wrist pain.
authors.forename: Kesaree
authors.initials: K
authors.lastname: Punlee
authors.forename: Wandee
authors.initials: W
authors.lastname: Rochanasiri
authors.forename: Vithaya
authors.initials: V
authors.lastname: Chaithiraphan
authors.forename: Suteera
authors.initials: S
authors.lastname: Phrudprisan
authors.forename: Akarin
authors.initials: A
authors.lastname: Nimmannit
authors.forename: Kamol
authors.initials: K
authors.lastname: Udol
mesh_terms: D000368:Aged; D001940:Breast / Q000033:anatomy & histology*; D004452:Echocardiography / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology*; D017060:Patient Satisfaction