Pocket carried ultrasound: its usefulness in clinical practice--a pilot study.

AIMS

To assess the diagnostic potential of the latest and smallest pocket carried ultrasound (PCU) in both normal and diseased hearts, to compare its imaging quality and information provided with a high end standard equipment (HSE), and how quickly a clinically meaningful information could be obtained.

METHODS

61 consecutive unselected patients, during the five days referral, formed the study material. 41 patients were outpatient referrals and 20 were bed side studies in either emergency room or intensive care units. Their mean age was 47 years. Every patient underwent two echocardiographic studies, first by the PCU and then followed by a detailed study with HSE. Standard echo planes were scanned and both 2- dimensional and color flow mapping studies were performed.

RESULTS

An interpretable scan by Hand carried ultrasound (HCU) was obtained in 57/61 patients. In only 3 cases mild LVH and mild cardiomegaly was missed by HCU, mainly because linear dimensions were not taken with HCU. In all other cases there was agreement between the two examinations which included cases with regional wall motion abnormalities (RWMA), pericarditis, valvular lesions etc. Evaluation of LV ejection fraction, whether normal or deranged, was correctly evaluated in 55/61 patients by both echo techniques. All 3 cases of cardiac murmur were correctly evaluated by HCU which included one case of mitral and tricuspid stenosis. HCU studies changed the management strategies of 2 cases, 1 showing RWMA which necessitated immediate intervention and 1 case of COPD which was diagnosed as dilated cardiomyopathy. The imaging quality of HCU as obtained on LCD screen was well comparable with HSE. The same applied to color flow mapping. The main advantage of HCU was a quick response time in emergency cases due to its easy portability. Moreover the time taken to get meaningful diagnostic information was 5 mins. and 30 secs.

CONCLUSION

The pocket held scanner is a substantial development in clinical decision making in a tertiary cardiac centre. It provides a rapid and accurate method in identifying patients both with normal and diseased hearts, thereby influencing their disposal both in OPD and emergency areas.