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How useful is hand-carried bedside echocardiography in critically ill patients?

^a Noninvasive Cardiology Laboratory, New York University School of Medicine, New York, New York, USA

View larger version (52K): [in a new window]   Figure 1 Systolic frame, long axis parasternal views in a patient with dyspnea: (A) hand-carried echocardiography (with color power Doppler); (B) standard echocardiography (with color Doppler). Note that severe mitral regurgitation was seen easily by standard echocardiography (B) and not by hand-carried echocardiography (A). Ao = aorta; LA = left atrium; LV = left ventricle.

View larger version (80K): [in a new window]   Figure 2 Systolic frame, apical four-chamber views in another patient with dyspnea: (A) hand-carried echocardiography (with color power Doppler) (arrow points to tricuspid regurgitation); (B) standard echocardiography (with color Doppler). Note that severe tricuspid regurgitation was seen easily in the right atrium by standard echocardiography (B) and not by hand-carried echocardiography (A). In addition, this patient has severe pulmonary hypertension (note continuous-wave Doppler with a 4-m/s velocity of tricuspid regurgitation [arrow] on standard echocardiography (C); this indicates a pulmonary artery systolic pressure of approximately 75 mm Hg). This critical information could not be obtained with hand-carried echocardiography, which lacks spectral Doppler. LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.