Necessity of Bedside Echocardiography for Patient with Different Clinical Conditions and Its Values in Diagnosis and Treatment

  Objective  To evaluate the necessity of bedside echocardiography (ECG) in patients with different clinical conditions and to investigate its values in diagnosis and treatment.

  Methods  We analyzed the clinical conditions of all the patients who applied for and received bedside ECG in Peking Union Medical College Hospital from July 1 to 30, 2013.The necessity of this examination and its values in the diagnosis and treatment were evaluated.

  Results  Fifty-eight patients were included (33 males, 56.9%), aged (56.4±19.9) years. Thirty-seven(63.8%) patients were from emergency department, 16 (27.6%) were from intensive care units, and 5(8.6%) from other departments. In 36 (62.1%) patients, the purpose of applications for bedside ECG was in compliance with the consensus of the American Society of Echocardiography (ASE) and American College of Emergency Physicians (ACEP). The purposes of bedside ECG were accomplished in 53(91.4%) applications.The bedside ECG confirmed or altered the initial diagnosis in 13(22.4%) cases, supported the initial diagnosis in 40 (69.0%), but offered no diagnostic information in 5 (8.6%). Based on the ECG results, the treatment was adjusted in 16 patients (27.6%). After the examination, 23(39.7%) applications for bedside ECG were considered necessary by cardiologists, the other 35 (60.3%) were unnecessary. Compared with the applications not conforming to the consensus of ASE and ACEP, those conforming to the consensus were significantly more likely to provide valuable diagnostic information (P=0.01), to result in treatment adjustment(P=0.06), and to be necessary (P < 0.01).

  Conclusions  The indications of bedside ECG should be strictly observed. To make full use of the limited medical resources, bedside ECG should be applied in accordance with the consensus of ASE and ACEP to ensure its values in diagnosis and treatment.