Prospective Evaluation of Two-dimensional Transthoracic Echocardiography in Emergency Department Patients with Suspected Pulmonary Embolism

摘要: . Objective: To prospectively examine the diagnostic accuracy of two-dimensional transthoracic echocardiography (2-D echo) in emergency department (ED) patients being evaluated for acute pulmonary embolism (PE). Methods: This was a 14-month prospective observational trial convenience sample ED undergoing evaluation suspected PE at suburban teaching hospital. The 2-D echo defined as positive if any two following were noted: right ventricular dilation, abnormal septal motion, loss contractility, elevated artery or pressures, moderate to severe tricuspid regurgitation, visualization clot seen ventricle artery. patient considered have one positive: angiogram, contrast helical computed tomography, magnetic resonance high-probability ventilation/perfusion (V/Q) scan without contradictory evidence, an intermediate-probability V/Q with ultrasonic evidence deep venous thrombosis. Results: Of 225 cases identified, 39 met criteria (17%). A performed on 124 (55%), whom 27 (22%) had PE. In 20 least indicators strain; however, only 11 these confirmed embolus. sensitivity 0.41 (95% CI = 0.32 0.49) and specificity 0.91 0.86 0.96). likelihood ratio moderately strong 4.4, weak negative 0.6. Conclusions: Bedside is not sensitive test diagnosis patients. Positive findings increase suspicion but are diagnostic.