[Appropriate diagnostics in emergency admission. Echocardiography]

Echocardiography is the central imaging modality for the diagnosis of myocardial, valvular and structural heart disease. Coronary artery disease can be detected by impaired left ventricular function. The rapid bedside application in unstable patients requiring immediate diagnostics and treatment is a decisive advantage of echocardiography. The so-called appropriateness criteria propose the use of echocardiography in the following emergency situations: (1) assessment of patients with hypotension or hemodynamic instability, (2) assessment of patients with myocardial ischemia or infarction, (3) evaluation of patients with respiratory failure and suspected cardiac origin and (4) application of echocardiography in suspected or proven pulmonary embolism for treatment decisions. Echocardiography also has an important impact in the differential diagnosis of chest pain symptoms. The application of echocardiography in the emergency department may set the course for understanding of the underlying disease processes as well as the required treatment strategy. Due to the operator dependency of the technique, a meaningful application of echocardiography requires an experienced investigator even in the emergency department.