The use of echocardiography in acute cardiovascular care: Recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association

Lancellotti, Patrizio; Price, Susanna; Edvardsen, Thor; Cosyns, Bernard; Nešković, Aleksandar N.; Flachskampf, Frank A.; Hassager, Christian; Pasquet, Agnès; Gargani, Luna; Galderisi, Maurizio; Cardim, Nuno; Haugaa, Kristina H; Ancion, Arnaud; Zamorano, José-Luis; Donal, Erwan; Bueno, Héctor; Habib, Gilbert

doi:10.1177/2048872614549739

Cited by 44 publications

(49 citation statements)

References 112 publications

(153 reference statements)

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“…Bedside focused cardiac ultrasound in the emergency department or intensive/coronary care unit is a first-line test in the assessment of RV size, function and load. 40,41 It can be used to exclude extrinsic causes of acute RV failure, especially those needing immediate treatment (such as pericardial tamponade which mimics acute RV failure), and to estimate right atrial pressure by assessing the diameter and the respiratory collapse of the inferior vena cava. The quantification of pulmonary artery systolic pressure by the trans-tricuspid pressure gradient is a reliable method compared with invasive measurements.…”

Section: Echocardiographic Assessmentmentioning

confidence: 99%

Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology

Harjola

Mebazaa

Čelutkienė

et al. 2016

European J of Heart Fail

486

427

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Acute right ventricular (RV) failure is a complex clinical syndrome that results from many causes. Research efforts have disproportionately focused on the failing left ventricle, but recently the need has been recognized to achieve a more comprehensive understanding of RV anatomy, physiology, and pathophysiology, and of management approaches. Right ventricular mechanics and function are altered in the setting of either pressure overload or volume overload. Failure may also result from a primary reduction of myocardial contractility owing to ischaemia, cardiomyopathy, or arrhythmia. Dysfunction leads to impaired RV filling and increased right atrial pressures. As dysfunction progresses 227to overt RV failure, the RV chamber becomes more spherical and tricuspid regurgitation is aggravated, a cascade leading to increasing venous congestion. Ventricular interdependence results in impaired left ventricular filling, a decrease in left ventricular stroke volume, and ultimately low cardiac output and cardiogenic shock. Identification and treatment of the underlying cause of RV failure, such as acute pulmonary embolism, acute respiratory distress syndrome, acute decompensation of chronic pulmonary hypertension, RV infarction, or arrhythmia, is the primary management strategy. Judicious fluid management, use of inotropes and vasopressors, assist devices, and a strategy focusing on RV protection for mechanical ventilation if required all play a role in the clinical care of these patients. Future research should aim to address the remaining areas of uncertainty which result from the complexity of RV haemodynamics and lack of conclusive evidence regarding RV-specific treatment approaches.

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Section: Echocardiographic Assessmentmentioning

confidence: 99%

Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology

Harjola

Mebazaa

Čelutkienė

et al. 2016

European J of Heart Fail

486

427

View full text Add to dashboard Cite

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“…depends on load conditions, inotropic medications and is not well studied during ventilatory support. 6,11 Global longitudinal strain is recommended by EACVI for the evaluation of cardiac performance in all AHF patients, indicating mild and severe dysfunction if reduced ≤16% and ≤10%, respectively 6 (online supplementary Video S5).…”

Section: Evaluation Of Ventricular Functionmentioning

confidence: 99%

Imaging in patients with suspected acute heart failure: timeline approach position statement on behalf of the Heart Failure Association of the European Society of Cardiology

Čelutkienė

Lainščak

Anderson

et al. 2019

European J of Heart Fail

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Acute heart failure is one of the main diagnostic and therapeutic challenges in clinical practice due to a non‐specific clinical manifestation and the urgent need for timely and tailored management at the same time. In this position statement, the Heart Failure Association aims to systematize the use of various imaging methods in accordance with the timeline of acute heart failure care proposed in the recent guidelines of the European Society of Cardiology. During the first hours of admission the point‐of‐care focused cardiac and lung ultrasound examination is an invaluable tool for rapid differential diagnosis of acute dyspnoea, which is highly feasible and relatively easy to learn. Several portable and stationary imaging modalities are being increasingly used for the evaluation of cardiac structure and function, haemodynamic and volume status, precipitating myocardial ischaemia or valvular abnormalities, and systemic and pulmonary congestion. This paper emphasizes the central role of the full echocardiographic examination in the identification of heart failure aetiology, severity of cardiac dysfunction, indications for specific heart failure therapy, and risk stratification. Correct evaluation of cardiac filling pressures and accurate prognostication may help to prevent unscheduled short‐term readmission. Alternative advanced imaging modalities should be considered to assist patient management in the pre‐ and post‐discharge phase, including cardiac magnetic resonance, computed tomography, nuclear studies, and coronary angiography. The Heart Failure Association addresses this paper to the wide spectrum of acute care and heart failure specialists, highlighting the value of all available imaging techniques at specific stages and in common clinical scenarios of acute heart failure.

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“…Furthermore, bedside echocardiography is important in early detection of acute myocardial infarction complications such as myocardial rupture (free wall or inter-ventricular septum) and acute mitral regurgitation. 77 These abnormalities can be detected using portable ultrasound device. 40,78 Pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity and can be present in case of chest pain due to pericarditis.…”

Section: A Ss E Ss Ment Of Patients With Che S T Painmentioning

confidence: 99%

Point‐of‐care ultrasound with pocket‐size devices in emergency department

2019

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Point‐of‐care ultrasound is a useful tool for clinicians in the management of patients. Particularly in emergency department, the role of point‐of‐care ultrasound is strongly increasing due to the need for a rapid assessment of critically ill patients and to speed up the diagnostic process. Hand‐carried ultrasound devices are particularly useful in emergency setting and allow rapid assessment of patient even in prehospital setting. This article will review the role of point‐of‐care ultrasonography, performed with pocket‐size devices, in the management of patients presenting with acute onset of undifferentiating dyspnea, chest pain, and shock in emergency department.

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The use of echocardiography in acute cardiovascular care: Recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association

Cited by 44 publications

References 112 publications

Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology

Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology

Imaging in patients with suspected acute heart failure: timeline approach position statement on behalf of the Heart Failure Association of the European Society of Cardiology

Point‐of‐care ultrasound with pocket‐size devices in emergency department

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