Dos Santos Jonathan, Borges Fernandes Patrícia, Rocha Gonçalves Francisco, Gonçalves Alexandra
ACeS Baixo Tâmega, UCSP Celorico de Basto, Assento, Britelo, 4890-221 Celorico de Basto, Portugal.
Department of Medicine, Faculty of Medicine of Porto University, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
Eur Heart J Case Rep. 2019 Oct 22;3(4):1-5. doi: 10.1093/ehjcr/ytz179. eCollection 2019 Dec.
Echocardiography has been traditionally performed in echo labs and the potential benefits of its use by primary care physicians (PCPs) are still unexplored. We present a case where POCUS (point-of-care ultrasound) was used as a complement of physical examination by a family doctor, allowing a prompt clinical decision in a heart failure (HF) patient.
An 85-year-old woman, living independently, asks her family doctor for a home consultation due to increasing dyspnoea. On examination, severe dyspnoea and bilateral ankle oedema was noted and a point-of-care echocardiogram was performed by the primary care physician, who observed: severely compromised left ventricular systolic function, moderate mitral and tricuspid regurgitation, and severe dilation of the inferior vena cava. As a result, the diagnosis of HF with decreased ejection fraction was formed supporting the therapeutic decision.
This case represents an elderly patient with dyspnoea, without previous HF diagnosis. The primary care physician, used portable ultrasound as a complement of physical examination, which confirmed a HF diagnosis, allowing a prompt decision-making on therapy. POCUS, can be a powerful tool to expedite treatment in different settings, including the home consultations by PCPs.
传统上，超声心动图检查是在超声实验室进行的，基层医疗医生（PCP）使用超声心动图的潜在益处仍未得到探索。我们介绍一个病例，家庭医生将即时超声检查（POCUS）用作体格检查的补充手段，从而能够对一名心力衰竭（HF）患者迅速做出临床决策。
一名85岁独立生活的女性因呼吸困难加重，请求家庭医生进行上门会诊。检查时，发现患者有严重呼吸困难和双侧脚踝水肿，基层医疗医生进行了即时超声心动图检查，观察到：左心室收缩功能严重受损、中度二尖瓣和三尖瓣反流以及下腔静脉严重扩张。由此，形成了射血分数降低的心力衰竭诊断，为治疗决策提供了依据。
该病例为一名有呼吸困难症状、既往无心力衰竭诊断的老年患者。基层医疗医生使用便携式超声作为体格检查的补充手段，确诊了心力衰竭，从而能够迅速做出治疗决策。即时超声检查（POCUS）可以成为在不同场景下加快治疗的有力工具，包括基层医疗医生进行的上门会诊。
