Point-of-care echocardiography for aortic dissection, pulmonary embolism and acute coronary syndrome in patients with killer chest pain: EASY screening focused on the assessment of effusion, aorta, ventricular size and shape and ventricular asynergy
- 529 Downloads
Focus assessed transthoracic echocardiography and focused cardiac ultrasound are point-of-care echo protocols for the evaluation of cardiac disease in the emergency room; however, these protocols may not adequately assess aortic dissection, pulmonary embolism, and acute coronary syndrome in patients with killer chest pain. Here, I present an echocardiography protocol focused on screening for these critical cardiovascular diseases. This protocol (termed EASY screening) consists of the assessment of effusion in the pericardial space, aortic abnormalities, the size and shape of the ventricles and asynergy of the left ventricle. Aortic dissection is suggested by positive findings for effusion and/or abnormal aortic findings. Pulmonary embolism is suggested by a dilated right ventricle and a D-shaped left ventricle in the short-axis view. Acute coronary syndrome is suggested by asynergy of left ventricular wall motion. EASY screening may facilitate the assessment of aortic dissection, pulmonary embolism and acute coronary syndrome in patients presenting to the emergency room with killer chest pain.
KeywordsPoint-of-care echocardiography Chest pain Aortic dissection Pulmonary embolism Acute coronary syndrome
Compliance with ethical standards
Conflict of interest
Kazuhiro Nishigami has received honoraria of $1,000 or less as a lecture fee from Astellas Pharma Inc., AstraZeneca K.K., Bayer Yakuhin Ltd., Boehringer Ingelheim Japan Inc., Kowa Pharmaceutical Co., Ltd., MSD K.K., Shionogi & Co., Ltd., Novartis Pharma K.K., Tanabemitsubishi Pharmaceutical Co., Ltd. and Takeda Pharmaceutical Co., Ltd.
Supplementary material 7 Movie 7: Parasternal short-axis view showing a straight interventricular septum and left ventricular deformity forming a D-shape (AVI 1369 kb)