alexa The impact of pre-operative focused transthoracic echocardiography in emergency non-cardiac surgery patients with known or risk of cardiac disease.


Journal of Anesthesia & Clinical Research

Author(s): Canty DJ, Royse CF, Kilpatrick D, Williams DL, Royse AG

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Abstract This prospective observational study investigated the effect of focused transthoracic echocardiography in 99 patients who had suspected cardiac disease or were ≥ 65 years old, and were scheduled for emergency non-cardiac surgery. The treating anaesthetist completed a diagnosis and management plan before and after transthoracic echocardiography, which was performed by an independent operator. Clinical examination rated cardiac disease present in 75\%; the remainder were asymptomatic. The cardiac diagnosis was changed in 67\% and the management plan in 44\% of patients after echocardiography. Cardiac disease was identified by echocardiography in 64\% of patients, which led to a step-up of treatment in 36\% (4\% delay for cardiology referral, 2\% altered surgery, 4\% intensive care and 26\% intra-operative haemodynamic management changes). Absence of cardiac disease in 36\% resulted in a step-down of treatment in 8\% (no referral 3\%, intensive care 1\% or haemodynamic treatment 4\%). Pre-operative focused transthoracic echocardiography in patients admitted for emergency surgery and with known cardiac disease or suspected to be at risk of cardiac disease frequently alters diagnosis and management. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland. This article was published in Anaesthesia and referenced in Journal of Anesthesia & Clinical Research

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