State-of-the-Art Review
Focused Cardiac Ultrasonography

https://doi.org/10.1016/j.jcmg.2018.12.036Get rights and content
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Highlights

  • FCU is an adjunct of the physical examination performed and interpreted at the point-of-care or bedside which demonstrably improves patient care, especially in acute circumstances.

  • FCU differs from echocardiography in being shorter and more focused on the presence or absence of a limited number of critical diagnoses which have immediate clinical consequences; it does not require full formal echocardiography or cardiology training but does require some dedicated and structured training.

  • Training pathways and their quality assurance, the range of its users, medicolegal and economic aspects, the role of focused cardiac ultrasonography with regard to standard echocardiography, the documentation and reporting of focused ultrasonography studies, and finally the potential technological advances such as artificial intelligence will need to be explored in the future.

Abstract

Focused cardiac ultrasonography (FCU) is the use of ultrasonography as an adjunct to physical examination at the point of care. There are ample data supporting the fact that noncardiology trained users using small ultrasonography devices can assess left ventricular (LV) enlargement, LV systolic dysfunction, right ventricular (RV) enlargement, left atrial (LA) enlargement, LV hypertrophy, pericardial effusion, and right atrial (RA) pressure elevation more accurately than performing a physical examination. In addition, FCU-trained providers may have skills to perform ultrasonography imaging of body systems outside the heart to supplement their cardiac evaluation. FCU training, including didactic education, proctored imaging, independent imaging, and image interpretation, has been established by several specialties and medical schools. Cardiologists should embrace FCU in their facilities, as the clinical value to patient care is clear. Cardiologists have the responsibility to maintain excellence in the practice of echocardiography while enabling the use of ultrasonography by other medical professionals to augment their clinical assessments conventionally based on physical examination alone.

Key Words

echocardiography
focused cardiac ultrasonography
point of care ultrasonography

Abbreviations and Acronyms

FCU
focused cardiac ultrasonography
LV
left ventricle
RAP
right atrial pressure
RV
right ventricle

Cited by (0)

Dr. Spencer was a member of the advisory committee for Philips Lumify. Dr. Flachskampf has reported that he has no relationships relevant to the contents of this paper to disclose.

Deceased.