Evaluation of Regional Wall Motion Abnormalities with Echocardiography in the Emergency Department

Yusuf Karancı, Cihan Bedel, F. Selvi, Ökkeş Zortuk
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Abstract

Introduction Acute coronary syndrome (ACS) is a major cardiovascular disease, particularly in cases where standard electrocardiogram findings are equivocal. Focused cardiac ultrasound (FOCUS) has become increasingly accepted as a tool in emergency medicine. The primary objective of this study was to evaluate the accuracy, sensitivity, and specificity of FOCUS in detecting regional wall motion abnormalities (RWMA) compared with standard echocardiography (ECHO). Materials and Methods This prospective observational study included 91 patients who presented to the emergency department between June 1, 2023, and November 30, 2023. Senior emergency physicians performed FOCUS examinations, which were performed by an emergency assistant or specialist who works in the emergency department, has at least 2 years of experience in ultrasonography (USG), and has basic USG and advanced USG certificates. The examinations assessed the presence of RWMA in each patient's left ventricle. Results All 91 patients were included in the study for comparison with formal ECHO. The mean age was 58, and 32% of patients were female. Compared with the criterion standard of formal ECHO, the sensitivity of FOCUS performed by emergency physicians for detecting RWMA was 85% (95% confidence interval [CI], 73–92), the specificity was 53% (95% CI, 36–69), and the overall accuracy was 74% (95% CI, 64–82). Conclusion Our study demonstrates the potential utility of FOCUS performed by emergency physicians in detecting RWMA in patients with high suspicion of ACS.
在急诊科使用超声心动图评估区域室壁运动异常
导言 急性冠状动脉综合征(ACS)是一种主要的心血管疾病,尤其是在标准心电图结果不明确的情况下。聚焦心脏超声(FOCUS)作为一种急诊医学工具已被越来越多的人所接受。本研究的主要目的是评估 FOCUS 与标准超声心动图(ECHO)相比在检测区域室壁运动异常(RWMA)方面的准确性、敏感性和特异性。材料与方法 该前瞻性观察研究纳入了 2023 年 6 月 1 日至 2023 年 11 月 30 日期间急诊科就诊的 91 名患者。由资深急诊医生进行 FOCUS 检查,检查由在急诊科工作的急诊助理或专家进行,他们至少有 2 年的超声波检查(USG)经验,并持有基础 USG 和高级 USG 证书。检查评估每位患者左心室是否存在 RWMA。结果 所有 91 名患者都被纳入研究,与正规的 ECHO 进行比较。患者平均年龄为 58 岁,32% 为女性。与正规 ECHO 的标准相比,急诊医生使用 FOCUS 检测 RWMA 的灵敏度为 85%(95% 置信区间 [CI],73-92),特异度为 53%(95% 置信区间 [CI],36-69),总体准确率为 74%(95% 置信区间 [CI],64-82)。结论 我们的研究表明,急诊医生使用 FOCUS 检测高度怀疑 ACS 患者的 RWMA 具有潜在的实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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