Cardiac Point-of-Care Ultrasound (POCUS) in Adolescents With Chest Pain or Syncope in the Emergency Department: Is There a Sex Discrepancy?

Cardiac POCUS is sometimes performed in patients with chest pain or syncope in the pediatric ED. It is possible that adolescent females are less likely to receive a scan due to provider discomfort with the potential obstruction of breast tissue. The primary aim of this study was to compare the proportion of cardiac POCUS obtained in adolescent males versus females to determine whether there is a difference. This was a retrospective chart review of adolescent patients who presented with chest pain or syncope from the year 2018 to 2020. Cardiac POCUS scans obtained on this cohort were reviewed, and the patients were then compared by sex to see whether there were differences in the number and proportion of scans obtained. The quality of the overall scans was also evaluated and compared to see whether there was a sex-based difference. Descriptive statistics was calculated, and differences were assessed by sex using χ 2 test. A total of 2814 patients were enrolled in the study; 1096 were male, and 1718 were female. Of those, 259 received cardiac POCUS; 132 (51%) were male and 127 (49%) were female. There was a significant difference in the proportion of patients who received cardiac POCUS, based on sex ( P <0.0001). There was no significant difference in the sex of the patient and the quality of the images obtained. Interrater reliability between a Pediatric Emergency Medicine fellow who has had cardiac POCUS training and a pediatric cardiologist was compared and yielded a kappa of 0.565. There was a significant difference in the sex of the patients who received cardiac POCUS for the complaint of chest pain or syncope.