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Bedside Echocardiography

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https://www.readbyqxmd.com/read/28317398/cardiac-transplantation-towards-a-new-noninvasive-approach-of-cardiac-allograft-rejection
#1
Sophie I Mavrogeni, George Athanasopoulos, Aggeliki Gouziouta, Evangelos Leontiadis, Stamatis Adamopoulos, Genovefa Kolovou
Cardiac allograft rejection (CAR) may occur after transplantation and remains silent, until hemodynamic deterioration takes place. Endomyocardial biopsy (EMB) is applied to early detect CAR. Although, flexible bioptoms have decreased the incidence of lethal complications, EMB remains an invasive procedure carrying risk of tamponade and permanent heart block. Therefore, a new non-invasive approach is needed. Areas covered: AlloMap molecular expression testing and graft-derived cell-free DNA (GcfDNA) test can be used as blood indices of acute and chronic CAR, respectively...
March 21, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28295525/advantages-and-pitfalls-of-pocket-ultrasound-vs-daily-chest-radiography-in-the-coronary-care-unit-a-single-user-experience
#2
Colin T Phillips, Warren J Manning
BACKGROUND: Pocket ultrasonography may enhance patient diagnosis and care. We sought to assess pocket ultrasound in detecting common conditions in the coronary care unit (CCU) compared to portable daily chest radiography (CXR) and conventional transthoracic echocardiography (TTE). METHODS: An experienced pocket ultrasound user performed a pocket ultrasound examination for interstitial edema, pneumonia, central line seen in the right ventricle, pleural and pericardial effusions, left atrial enlargement, and cardiomegaly...
March 14, 2017: Echocardiography
https://www.readbyqxmd.com/read/28291128/the-use-of-ultrasound-in-obstetric-anesthesia
#3
Carolyn F Weiniger, Limor Sharoni
PURPOSE OF REVIEW: The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. RECENT FINDINGS: The review presents the most recent literature describing ultrasound-guided airway assessments, airway management, cricothyroidotomy, transthoracic echocardiography, gastric volume assessments, point-of-care lung ultrasound diagnoses, intracranial pressure assessments, vascular access, neuraxial blocks, and transversus abdominis plane blocks...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28279544/inferior-vena-cava-filter-limb-fracture-with-embolization-to-the-right-ventricle
#4
Bradley S Jackson, Mykel Sepula, Jared T Marx, Chad M Cannon
BACKGROUND: Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. CASE REPORT: A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28269217/non-invasive-monitoring-of-pulmonary-artery-pressure-at-the-bedside
#5
M Proenca, F Braun, E Muntane, J Sola, A Adler, M Lemay, J-Ph Thiran, S F Rimoldi
Current solutions for the monitoring of pulmonary artery pressure (PAP) in patients suffering from pulmonary hypertension are limited to invasive means. Non-invasive alternatives, such as Doppler echocardiography, are incompatible with continuous monitoring due to their dependency on qualified personnel to perform the measurements. In the present study, a novel non-invasive and unsupervised approach based on the use of electrical impedance tomography (EIT) is presented. The approach was evaluated in three healthy subjects undergoing hypoxia-induced variations in PAP...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227447/non-invasive-monitoring-of-pulmonary-artery-pressure-at-the-bedside
#6
M Proenca, F Braun, E Muntane, J Sola, A Adler, M Lemay, J-Ph Thiran, S F Rimoldi, M Proenca, F Braun, E Muntane, J Sola, A Adler, M Lemay, J-Ph Thiran, S F Rimoldi, S F Rimoldi, E Muntane, J Sola, M Lemay, A Adler, J-Ph Thiran, F Braun
Current solutions for the monitoring of pulmonary artery pressure (PAP) in patients suffering from pulmonary hypertension are limited to invasive means. Non-invasive alternatives, such as Doppler echocardiography, are incompatible with continuous monitoring due to their dependency on qualified personnel to perform the measurements. In the present study, a novel non-invasive and unsupervised approach based on the use of electrical impedance tomography (EIT) is presented. The approach was evaluated in three healthy subjects undergoing hypoxia-induced variations in PAP...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28197055/pericardial-effusion-and-cardiac-tamponade-following-percutaneously-inserted-central-line-insertion-in-an-extremely-low-birth-weight-baby-case-report-and-successful-management
#7
Avinash V Desai, Abnish Kumar, Praful Shanbhag, Forum Shah
Pericardial effusion and cardiac tamponade are rare complications of percutaneously inserted central lines (PICLs), in extremely low-birth-weight babies. This particular complication carries a high degree of mortality, if not suspected and diagnosed. Bedside echocardiography proves not only diagnostic but also can be lifesaving in these conditions. Here, we wish to report such a baby who suddenly deteriorated and showed cardiovascular instability 2 days after the insertion of PICL. Immediate bedside echocardiography helped pick up the effusion which was drained using a subxiphoid percutaneous approach...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28188323/contrast-echocardiography-for-detection-of-myocardial-perfusion-abnormalities-a%C3%A2-clinical-perspective
#8
N Karogiannis, R Senior
Myocardial contrast echocardiography (MCE) is a well-established imaging technique in the assessment of patients with known or suspected coronary artery disease. The use of ultrasound contrast agents has optimized the evaluation of left ventricular function and, moreover, permits simultaneous assessment of the myocardial perfusion. This technique utilizes microbubbles that remain in the intravascular space and the contrast intensity reflects the concentration of the microbubbles in the myocardium. A homogeneous opacification of the myocardium after destruction of the microbubbles during high-power imaging is regarded as normal perfusion and absence of CAD...
February 10, 2017: Herz
https://www.readbyqxmd.com/read/28151822/clinical-significance-of-portal-hypertension-diagnosed-with-bedside-ultrasound-after-cardiac-surgery
#9
André Y Denault, William Beaubien-Souligny, Mahsa Elmi-Sarabi, Roberto Eljaiek, Ismail El-Hamamsy, Yoan Lamarche, Alexandra Chronopoulos, Jean Lambert, Josée Bouchard, Georges Desjardins
BACKGROUND: Portal venous flow pulsatility detected by Doppler ultrasound is a sign of congestive heart failure in noncritically ill patients. The assessment of portal and splenic venous flows has never been reported in patients undergoing cardiac surgery. METHODS: This is a case series performed in patients undergoing cardiac surgery between February 2014 and February 2015 in which portal and/or splenic venous flows were assessed by the attending anesthesiologist during surgery or by the intensivist after surgery using transthoracic echography in 9 patients or transesophageal echocardiography in 5 patients...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28117110/hemorrhagic-pericardial-cyst-diagnosis-accelerated-by-emergency-physician-echocardiography-a-case-report
#10
Michael F Yip, Brooks M Walsh
BACKGROUND: The differential diagnosis for chest pain in the emergency department is broad and includes both benign and life-threatening conditions-with pericardial cyst as a rare example. Emergency physician-performed point-of-care focused cardiac ultrasound (FOCUS) is increasingly recognized as a useful modality in the evaluation of patients with chest pain. CASE REPORT: We report a case of hemorrhagic pericardial cyst in a young woman presenting with chest pain in which findings on FOCUS contradicted findings on chest x-ray study and thus, accelerated diagnosis and definitive treatment...
January 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28099422/relationship-between-perfusion-index-and-patent-ductus-arteriosus-in-preterm-infants
#11
Enrique Gomez-Pomar, Majd Makhoul, Philip M Westgate, Katrina T Ibonia, Abhijit Patwardhan, Peter J Giannone, Henrietta Bada, Elie G Abu Jawdeh
BACKGROUND: Perfusion index (PI) is a noninvasive measure of perfusion. ΔPI (difference between pre and post-ductal PI) may identify hemodynamically significant PDA. However, studies are limited to brief and intermittent ΔPI sampling. Our objective is to assess the value of continuous high resolution ΔPI monitoring in the diagnosis of PDA. METHODS: Continuous ΔPI monitoring in preterm infants was prospectively performed using two high resolution pulse oximeters...
January 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#12
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28041756/trauma-induced-acute-myocardial-infarction-due-to-delayed-dissection-of-the-left-anterior-descending-coronary-artery
#13
Magdalena Wilczynska-Golonka, Pawel Rostoff, Aleksander Siniarski, Agnieszka Skrzypek, Andrzej Gackowski, Ewa Konduracka, Jadwiga Nessler
Acute myocardial infarction is a very rare, life-threatening complication of blunt chest trauma. A 27-year-old man with no previous medical history was admitted to the emergency department due to multiple trauma following a car accident. After 48h following the accident, the patient's condition rapidly deteriorated, with severe dyspnea at rest, tachycardia, and increasing chest pain. A 12-lead ECG showed a sinus tachycardia at 120bpm with significant ST-segment elevation in leads V1 to V5, pathologic Q wave in I, aVL, and QS complex in leads V1 to V4...
December 27, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28031691/cardiac-tamponade-after-right-ventricular-perforation-caused-by-screw-in-lead
#14
Lovel Giunio, Teo Boric, Cristijan Bulat, Dragan Dragicevic, Mislav Lozo
A 69-year-old man was admitted after syncope followed with chest pain and signs of cardiac tamponade. He had undergone permanent dual-chamber pacemaker implantation 3 weeks earlier. Transthoracic echocardiography (TTE) confirmed a pericardial effusion, and urgent pericardial drainage was performed. Right ventricular perforation caused by active-fixation (screw-in) lead was verified by multislice computed tomography. The lead was extracted under fluoroscopy and bedside TTE monitoring in the operating room with cardiothoracic surgery backup...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28031086/respiratory-and-cardiac-characteristics-of-icu-patients-aged-90-years-and-older-a-report-of-12-cases
#15
Hong-Min Zhang, Da-Wei Liu, Xiao-Ting Wang, Yun Long, Quan-Hui Yang
Objective To investigate the respiratory and cardiac characteristics of elderly Intensive Care Unit (ICU) patients.Methods Twelve senior ICU patients aged 90 years and older were enrolled in this study. We retrospectively collected all patients' clinical data through medical record review. The basic demographics, primary cause for admission, the condition of respiratory and circulatory support, as well as prognosis were recorded. Shock patients and pneumonia patients were specifically analyzed in terms of clinical manifestations, laboratory variables, echocardiography, and lung ultrasound Results...
March 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/27982544/cardiovascular-preclinical-imaging
#16
Stephan G Nekolla, Christoph Rischpler, Anna Paschali, Constantinos Anagnostopoulos
Non-invasive imaging in the form of single-photon emission-computed tomography (SPECT), positron-emission tomography (PET), computed tomography (CT), echocardiography or magnetic resonance imaging (MRI) is a very useful tool for cardiovascular research as it allows assessment of biological processes in vivo. Nuclear imaging with SPECT and PET offers the advantage of high sensitivity, the potential for serial imaging, and reliable quantification. Currently a wide range of established as well as innovative agents is available and can be imaged with dedicated preclinical and clinical SPECT and PET imaging systems...
March 2017: Quarterly Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/27981285/utility-of-transthoracic-echocardiography-tte-in-assessing-fluid-responsiveness-in-critically-ill-patients-a-challenge-for-the-bedside-sonographer
#17
Wojciech Mielnicki, Agnieszka Dyla, Tomasz Zawada
Transthoracic echocardiography (TTE) has become one of the most important diagnostic tools in the treatment of critically ill patients. It allows clinicians to recognise potentially reversible life-threatening situations and is also very effective in the monitoring of the fluid status of patients, slowly substituting invasive methods in the intensive care unit. Hemodynamic assessment is based on a few static and dynamic parameters. Dynamic parameters change during the respiratory cycle in mechanical ventilation and the level of this change directly corresponds to fluid responsiveness...
December 5, 2016: Medical Ultrasonography
https://www.readbyqxmd.com/read/27907878/ultrasound-in-cardiac-trauma
#18
Theodosios Saranteas, Andreas F Mavrogenis, Christina Mandila, John Poularas, Fotios Panou
In the perioperative period, the emergency department or the intensive care unit accurate assessment of variable chest pain requires meticulous knowledge, diagnostic skills, and suitable usage of various diagnostic modalities. In addition, in polytrauma patients, cardiac injury including aortic dissection, pulmonary embolism, acute myocardial infarction, and pericardial effusion should be immediately revealed and treated. In these patients, arrhythmias, mainly tachycardia, cardiac murmurs, or hypotension must alert physicians to suspect cardiovascular trauma, which would potentially be life threatening...
April 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27857899/hypoglycemia-and-revisable-st-elevation-induced-by-movento
#19
Mohammad Moshiri, Seyed Reza Mousavi, Leila Etemad
Spirotetramat (STM), an active ingredient of insecticide Movento 100 suspension concentrate (M100), is an inhibitor of acetyl-CoA carboxylase (ACC). The ACC is catalyst of acetyl-CoA to malonyl-CoA (MCA) reaction. MCA is the rate limiting steps of fatty acid biosynthesis. An 18-years-old man, who was referred to our ward from a local hospital, ingested 100 ml of M100, 18 h before. When we visited him, he was confused with stable vital signs and complained of vomiting and epigastric discomfort. He experienced hypoglycemia (blood sugar = 31 mg/dl) that was treated by hypertonic 20% dextrose serum and continued by maintenance DW10% (100 ml/h) up to 3 h...
October 2016: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/27802866/point-of-care-ultrasonography-as-a-training-milestone-for-internal-medicine-residents-the-time-is-now
#20
Bruce F Sabath, Gurkeerat Singh
Point-of-care (POC) ultrasonography is considered fundamental in emergency medicine training and recently has become a milestone in critical care fellowship programs as well. Currently, there is no such standard requirement for internal medicine residency programs in the United States. We present a new case and briefly review another case at our institution - a community hospital - in which internal medicine house staff trained in ultrasonography were able to uncover unexpected and critical diagnoses that significantly changed patient care and outcomes...
2016: Journal of Community Hospital Internal Medicine Perspectives
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