The emerging role of echocardiography in the emergency department

Cardiac ultrasound quickly provides both anatomic and physiologic assessment of the heart at the bedside, permitting rapid diagnosis and triage of patients presenting to the emergency department with chest pain, hypotension, or dyspnea. The identification and quantification of left ventricular dysfunction by ultrasound allows effective determination of prognosis and, thus, may supplant the ECG in patient triage. Transesophageal echocardiography definitively identifies the presence of thoracic aortic dissections, and this information may be obtained more immediately than by other imaging methods. Emergency physicians should have, at a minimum, sufficient knowledge of echocardiography to know when it is applicable to a patient problem. It may be feasible for noncardiologists to gain sufficient proficiency in echocardiography to use the technique as a screening procedure in the emergency department setting.