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{\u0022basePath\u0022:\u0022\\\/\u0022,\u0022pathPrefix\u0022:\u0022\u0022,\u0022highwire\u0022:{\u0022markup\u0022:[{\u0022requested\u0022:\u0022full-text\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;14\\\/54\\\/28\u0022},{\u0022requested\u0022:\u0022long\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;14\\\/54\\\/28\u0022}],\u0022ac\u0022:{\u0022spmdc;14\\\/54\\\/28\u0022:{\u0022access\u0022:{\u0022reprint\u0022:true,\u0022full\u0022:true},\u0022pisa_id\u0022:\u0022spmdc;14\\\/54\\\/28\u0022,\u0022atom_uri\u0022:\u0022\u0022,\u0022jcode\u0022:\u0022spmdc\u0022}}},\u0022googleanalytics\u0022:{\u0022trackOutbound\u0022:1,\u0022trackMailto\u0022:1,\u0022trackDownload\u0022:1,\u0022trackDownloadExtensions\u0022:\u00227z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip\u0022,\u0022trackUrlFragments\u0022:1},\u0022ajaxPageState\u0022:{\u0022js\u0022:{\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/jquery.cluetip.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.hoverIntent.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.bgiframe.min.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_at_symbol.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_article_reference_popup.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/contrib\\\/google_analytics\\\/googleanalytics.js\u0022:1,\u00220\u0022:1}}});\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Clink type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003ETimely evaluation of patients presenting with symptoms of acute heart failure is crucial to making a prompt diagnosis and selecting appropriate therapeutic measures. Using echocardiography, the clinician can quickly and noninvasively obtain information about the causal condition, critical hemodynamic factors, and the etiology of lung congestion.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eheart failure\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eleft ventricular dysfunction\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eregurgitation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehemodynamic assessment\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Elung congestion\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EAcute heart failure (AHF) is a complex multifactorial syndrome with diverse primary and secondary causes, different phenotypic pathways of progression, and varied responses to therapies. Careful evaluation of patients presenting with AHF symptoms is essential to initiating prompt, appropriate therapy. The presentations in this session addressed the role of echocardiography in the diagnosis and evaluation of AHF.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EImaging Diagnosis of AHF\u003C\/h2\u003E\u003Cp id=\u0022p-3\u0022\u003EEchocardiography can be a powerful tool for diagnosing and monitoring patients with AHF. However, there are many challenges in the imaging diagnosis of heart failure in the acute setting. Susanna Price, MD, Royal Brompton College, London, United Kingdom, discussed the diagnostic challenges, potential pitfalls, and a systematic approach to the diagnosis of AHF.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe use of transthoracic echocardiography (TTE) or transesophageal echocardiography to diagnose AHF may be determined by the patient characteristics and the underlying cause of AHF. Any findings must be interpreted in the specific clinical context, including arrest or peri-arrest, chest pain, acute dyspnea, shock, deterioration in the intensive care unit (ICU), and failure to wean from mechanical ventilation. The recent recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association [Lancelotti P et al. \u003Cem\u003EEur Heart J Acute Cardiovasc Care.\u003C\/em\u003E 2014] on the use of echocardiography in acute cardiovascular (CV) care describe conditions associated with AHF symptoms that can be diagnosed with echocardiography (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/11604\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/11604\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11604\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003ESpecific Conditions Associated With Acute Heart Failure Symptoms That Can Be Diagnosed With Echocardiography\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003EIn addition to helping to clarify the underlying cause of AHF, echocardiography can be used in the cardiac arrest\/peri-arrest setting to determine the presence or absence of cardiac activity for prognosis after resuscitation [Salen P et al. \u003Cem\u003EAm J Emerg Med.\u003C\/em\u003E 2005]; exclude potentially treatable causes such as tamponade, myocardial insufficiency, and hypovolemia; and guide interventions [Bocka JJ et al. \u003Cem\u003EAnn Emerg Med.\u003C\/em\u003E 1988]. According to the 2010 resuscitation guidelines from the International Consensus on Cardiopulmonary Resuscitation [\u003Cem\u003ECirculation.\u003C\/em\u003E 2010], ultrasound can help identify reversible causes of cardiac arrest, but only if used appropriately so as to minimize interruptions to chest compression. The guidelines recommend using a subxiphoid probe position. By placing the probe just before chest compressions are paused for a planned rhythm assessment, a well-trained operator can obtain views within 10 seconds.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EShock due to left ventricular (LV) dysfunction is the leading cause of mortality in patients with acute myocardial infarction (AMI). The admission ejection fraction (EF) does not correlate with the long-term outcome. Inotropic agents, sedating drugs, and positive pressure ventilation may significantly alter contractility, potentially confounding the association with EF and long-term outcomes. Parameters to assess left atrial pressure (LAP) may be challenging in the ICU. Isolated right ventricular (RV) infarction is unusual but RV failure secondary to respiratory disease is much more common. Acute cor pulmonale is associated with increased ICU mortality in patients with acute respiratory distress syndrome. Echocardiography findings can be inconsistent with respect to biventricular involvement, elevated LAP, and elevated pulmonary artery diastolic pressure.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003ECharacterizing severe valve disease can be complex in patients with AHF. Considerations for echocardiography in the diagnosis of AHF due to mitral and aortic regurgitation are listed in \u003Ca id=\u0022xref-table-wrap-2-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T2\u0022\u003ETable 2\u003C\/a\u003E.\u003C\/p\u003E\u003Cdiv id=\u0022T2\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/11607\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/11607\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11607\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 2.\u003C\/span\u003E \u003Cp id=\u0022p-11\u0022 class=\u0022first-child\u0022\u003EEchocardiography Considerations in Diagnosis of Acute Heart Failure Caused by Mitral and Aortic Regurgitation\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-14\u0022\u003EAccording to Dr Price, the first principles in diagnostic imaging for the acutely\/critically unwell patient with AHF are to help clarify the underlying diagnosis, to provide information as to the adequacy of the patient\u2019s cardiac output, and to assist in therapeutic decision making. If cardiac output is inadequate and\/or venous pressure is excessive, corrective circulatory manipulations should be undertaken to optimize hemodynamics on either the right or left side. Mechanical circulatory support may be needed for patients with persistent inadequate cardiac output.\u003C\/p\u003E\u003Cp id=\u0022p-15\u0022\u003EIn summary, AHF is a syndrome, not a diagnosis. Failure to diagnose and treat the underlying cause results in a poor prognosis. After excluding obvious diagnoses, the less apparent causes of inadequate cardiac output or high venous pressure should be considered. Timely diagnosis of ineffective therapies and prompt referral for advanced therapies may be life-saving.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-3\u0022\u003E\u003Ch2 class=\u0022\u0022\u003ELUS in AHF\u003C\/h2\u003E\u003Cp id=\u0022p-16\u0022\u003ELuna Gargani, MD, Institute of Clinical Physiology, Pisa, Italy, discussed the use of ultrasound imaging of the lungs in patients with AHF. Lung ultrasound (LUS) has recently emerged as a new technique for the evaluation of pulmonary conditions [Moore CL, Copel JA. \u003Cem\u003EN Eng J Med.\u003C\/em\u003E 2011]. In a lung full of air, there is a high acoustic mismatch between the lung and the surrounding tissue, causing ultrasound to be reflected back. However, in cases where an exudate, fibrous tissue, or other substance displaces the air, ultrasound can penetrate the lung. For example, in interstitial edema, the ultrasound image shows B-lines, which are discrete laser-like vertical hyperechoic reverberation artifacts arising from the pleural line. The less air that is present in the lung, the more B-lines that will be observed. With extreme air loss, artifacts are no longer seen and the pulmonary parenchyma is directly visualized.\u003C\/p\u003E\u003Cp id=\u0022p-17\u0022\u003ELUS is important for assessing pulmonary congestion in AHF because of the association between pulmonary congestion and poor prognosis [Fonarow GC, Weber JE. \u003Cem\u003EClin Cardiol\u003C\/em\u003E. 2004]. Pulmonary edema can be distinguished from chronic obstructive pulmonary disease by the presence of B-lines on LUS. Additionally, the B-lines have been correlated with natriuretic peptides, which are useful in the differential diagnosis of cardiac dyspnea from noncardiac dyspnea [Gargani L et al. \u003Cem\u003EEur J Heart Fail.\u003C\/em\u003E 2008].\u003C\/p\u003E\u003Cp id=\u0022p-18\u0022\u003ELUS can be performed with any 2D scanner, including pocket-size devices with the patient in the near-supine, supine, sitting, or standing position. The absence of diffuse, bilateral multiple B-lines excludes pulmonary edema of cardiac origin with 100% negative predictive value [Neskovic AN et al. \u003Cem\u003EEur Heart J.\u003C\/em\u003E 2012]. LUS is used primarily during admission as a point-of-care technique [Gargani L, Volpicelli G. \u003Cem\u003ECardiovasc Ultrasound.\u003C\/em\u003E 2014] and is effective for the diagnosis and monitoring of pulmonary congestion in AHF patients in this setting [Volpicelli G et al. \u003Cem\u003EAm J Emerg Med.\u003C\/em\u003E 2008].\u003C\/p\u003E\u003Cp id=\u0022p-19\u0022\u003EThe presence of comet-tail B-lines has prognostic value, as shown in an analysis of patients with AHF [Gargani L et al. EuroEcho. 2011]. Patients with \u0026lt;\u20095 B-lines had a significantly higher event-free survival rate vs those with \u2265\u200930 B-lines (\u003Cem\u003EP\u2009\u0026lt;\u2009\u003C\/em\u003E.001).\u003C\/p\u003E\u003Cp id=\u0022p-20\u0022\u003EB-lines are a nonspecific sign of interstitial syndrome but their distribution and other LUS features can distinguish acute cardiogenic pulmonary edema from other interstitial syndromes (\u003Ca id=\u0022xref-table-wrap-3-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T3\u0022\u003ETable 3\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T3\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/11610\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/11610\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11610\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 3.\u003C\/span\u003E \u003Cp id=\u0022p-21\u0022 class=\u0022first-child\u0022\u003EFeatures Distinguishing Etiology of Interstitial Syndrome by Lung Ultrasound\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-4\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EPCE Is a Must\u003C\/h2\u003E\u003Cp id=\u0022p-23\u0022\u003EAHF is categorized according to hemodynamic type, based on LVEF and volume status. Therefore, immediate hemodynamic assessment is essential for prompt initiation of appropriate therapy. In this presentation, Nuno Cardim, MD, Hospital da Luz, Lisbon, Portugal, discussed the emergency echocardiographic evaluation of patients with symptoms of AHF.\u003C\/p\u003E\u003Cp id=\u0022p-24\u0022\u003EInvasive hemodynamic assessment procedures are associated with complications. On the other hand, echocardiographic evaluation is quick and noninvasive. Echocardiography can be performed at the patient\u2019s bedside to provide information on cardiac function, intravascular volume, preload, contractility, and afterload. Preload measurements are well validated and more accurate than those obtained from pulmonary artery catheters. A study of 799 patients at their first admission for AHF showed that those evaluated with echocardiography had a significantly lower mortality rate at 36 months than patients evaluated without echocardiography (HR, 0.61; 95% CI, 0.48 to 0.78; \u003Cem\u003EP\u2009\u003C\/em\u003E\u0026lt;\u003Cem\u003E\u2009\u003C\/em\u003E.001) [Tribouilloy C et al. \u003Cem\u003EArch Cardiovasc Dis.\u003C\/em\u003E 2008]. Studies of patients evaluated with TTE in the ICU have demonstrated changes in diagnosis and management but no difference in patient outcomes [Orme RM et al. \u003Cem\u003EBr J Anaesth.\u003C\/em\u003E 2009; Stanko LK et al. \u003Cem\u003EAnaesth Intensive Care.\u003C\/em\u003E 2005].\u003C\/p\u003E\u003Cp id=\u0022p-25\u0022\u003EPoint-of-care echocardiography (PCE) with focused cardiac ultrasound (FoCUS) should be distinguished from comprehensive echocardiographic studies. FoCUS involves limited CV examination with ultrasound as an adjunct to the physical examination to obtain specific ultrasonic signs representing a narrow list of potential diagnostic data in a specific setting, using a predefined image acquisition protocol with the minimum and most efficient echocardiographic views. Comprehensive echocardiography and point-of-care FoCUS are compared in \u003Ca id=\u0022xref-table-wrap-4-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T4\u0022\u003ETable 4\u003C\/a\u003E.\u003C\/p\u003E\u003Cdiv id=\u0022T4\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/11614\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/11614\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11614\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 4.\u003C\/span\u003E \u003Cp id=\u0022p-26\u0022 class=\u0022first-child\u0022\u003EPoint-of-Care Focused Cardiac Ultrasound Compared With Comprehensive Echocardiography\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-30\u0022\u003EPCE is performed and interpreted by the healthcare provider in real time, directly correlating information with clinical data, without an intermediary imaging consultant [Marum S, Price S. \u003Cem\u003ECurr Cardiol Rev.\u003C\/em\u003E 2011]. The result is an early diagnosis and immediate therapy, without the risk of transporting acutely ill patients to other hospital departments. Disadvantages of PCE include the lack of continuous monitoring and the inability to acquire all of the classic echocardiographic views in some patients. PCE usually is equivalent to FoCUS but using the term focused cardiac ultrasound point-of-care (FoCUS-POC) instead of PCE stresses its difference from emergency echocardiography, which is a comprehensive, full echocardiographic study.\u003C\/p\u003E\u003Cp id=\u0022p-31\u0022\u003EFoCUS-POC provides immediate guidance for therapeutic management. Key parameters that can be assessed with FoCUS-POC include volume status, ventricular function, and pericardial effusion (\u003Ca id=\u0022xref-table-wrap-5-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T5\u0022\u003ETable 5\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T5\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/11616\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/11616\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11616\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 5.\u003C\/span\u003E \u003Cp id=\u0022p-32\u0022 class=\u0022first-child\u0022\u003EAssessment of Key Parameters With FoCUS-POC\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-35\u0022\u003EAccording to Prof Cardim, FoCUS-POC is essential for the evaluation of patients with AHF, especially when complete echocardiography is not available. LV function and volume status are the minimum data needed for early diagnosis and immediate therapy. However, the FoCUS key points must not be forgotten: identify basic but critical cardiac pathology; FoCUS may provide sufficient information for mostly qualitative, gross assessment of morphology and function; and FoCUS should be used wisely, but cautiously, with awareness of its relevant limitations. Education and training on FoCUS are necessary, as are supervision, quality control, and reporting.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/54\/28.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzobw1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzobw1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}