Bedside focused cardiac ultrasound in the evaluation of systolic dysfunction

Excerpt

The assessment of left ventricular systolic function (LVSF) plays a crucial role in the diagnosis, management and risk stratification of many cardiac diseases, such as myocarditis, acute coronary syndrome (ACS) and heart failure (HF). Transthoracic echocardiographic (TTE) imaging is the method of choice to evaluate LVSF because of its high accuracy, safety, and low cost; however, formal TTE may not be always immediately available [1]. History, physical examination, chest X-ray study, serum chemistries and electrocardiography have poor accuracy in identifying impaired LVSF [1, 2]. The delay in performing a TTE may be harmful in unstable patients: shock, dyspnoea and chest pain are the main symptoms requiring a bedside echocardiography in the medical emergency setting. Distinguishing patients with impaired LVSF is of pivotal importance to identify the correct therapeutic strategy as is true on medical wards, particularly when approaching patients with decompensated HF or volume-depleted patients. Moreover, early recognition of impaired LVSF permits an avoidance of harmful therapies. …