POCUS Cardiology
INTRODUCTION
Point-of-care ultrasonography (POCUS) has revolutionized the diagnosis and management of cardiovascular conditions, particularly in the context of heart failure. It enhances the sensitivity of traditional physical examination, allowing for the detection of signs such as left ventricular systolic dysfunction, left atrial enlargement, lung congestion, and elevated central venous pressures (Kimura 2017). POCUS is also valuable in assessing and monitoring volume status in heart failure patients, with a focus on the heart, venous system, and extravascular lung water/ascites (Koratala 2021). In the critical care setting, POCUS is commonly used for basic cardiac, lung, and abdominal ultrasound, with protocols integrating these modalities (Lau 2022). Its role in the diagnosis of various cardiovascular diseases, including acute and chronic heart failure, valvular heart diseases, and more, is well-established (Martinez 2023). POCUS can change diagnosis and management decisions in a range of cardiovascular conditions, making it a useful adjunct to the physical exam, particularly in critical care applications (Kovell 2018). Its wide applicability and utility in daily clinical practice make it an essential tool for hospitalists (Thind 2021). In the perioperative arena, POCUS is a valuable tool for cardiothoracic anesthesiologists, aiding in clinical decision-making across various contexts (Kalagara 2021).
Learning Objectives
- Recognize the Indications and Limitations of Cardiac POCUS
- Describe scenarios where cardiac POCUS is beneficial in emergency and critical care settings.
- Discuss the limitations and potential pitfalls of POCUS in assessing cardiac function.
- Develop Skills in Transducer Handling and Image Acquisition
- Demonstrate proper transducer manipulation techniques for optimal image acquisition.
- Recognize common artefacts and how to minimize them.
- Learn the Standard Cardiac Views and Their Interpretation
- Identify and obtain standard echocardiographic views (parasternal long and short axis, apical four-chamber, subcostal, and IVC views).
- Describe key structures visible in each view and their relevance in a clinical setting.
- Assess Basic Cardiac Function and Anatomy
- Evaluate left and right ventricular size and function.
- Recognize signs of common pathologies such as pericardial effusion, cardiomyopathies, and valvular abnormalities.
- Apply POCUS in Clinical Decision Making
- Integrate POCUS findings with clinical assessments to manage acute cardiac conditions.
- Discuss case studies where cardiac POCUS influenced patient outcomes.
