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Journal of Echocardiography

, Volume 13, Issue 4, pp 141–144 | Cite as

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

  • Kazuhiro NishigamiEmail author
Review Article

Abstract

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.

Keywords

Point-of-care echocardiography Chest pain Aortic dissection Pulmonary embolism Acute coronary syndrome 

Notes

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

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Supplementary material 1 Movie 1: Transthoracic pulmonary echo showing the disappearance of lung sliding due to respiration (AVI 1412 kb)
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Supplementary material 2 Movie 2: Left parasternal long-axis view showing effusion in the pericardial space (AVI 1268 kb)
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Supplementary material 3 Movie 3: Left parasternal cardiovascular view on a small scale showing the long-axis view of the descending aorta and a flap (AVI 1149 kb)
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Supplementary material 4 Movie 4: Left parasternal cardiovascular view from the superior intercostal showing the ascending aorta along with wall thickening (AVI 1192 kb)
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Supplementary material 5 Movie 5: Parasternal cardiovascular view on a small scale showing the short-axis with crescent-shaped wall thickening (AVI 4670 kb)
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Supplementary material 6 Movie 6: Parasternal long-axis view showing a dilated right ventricle. The diameter of the right ventricle is longer than that of the left ventricle (AVI 1317 kb)

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)

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Supplementary material 8 Movie 8: Apical long-axis view showing asynergy of the anteroseptal wall (AVI 2687 kb)
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Supplementary material 9 Movie 9: Parasternal short-axis view showing asynergy of the basal inferior wall (AVI 3692 kb)
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Supplementary material 10 Movie 10: Parasternal long-axis view showing asynergy of the posterior wall (AVI 3105 kb)
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Supplementary material 11 Movie 11: Parasternal short-axis view showing extensive asynergy of the left ventricle, except for the inferior wall (AVI 669 kb)

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Copyright information

© Japanese Society of Echocardiography 2015

Authors and Affiliations

  1. 1.Department of Critical Care and CardiologySaiseikai Kumamoto HospitalKumamotoJapan

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