Feasibility of "limited" echo imaging: characterization of incidental findings

To evaluate the feasibility of limiting the extent of the echocardiographic examination without omitting significant incidental findings, we reviewed consecutive reports from full echo studies performed in a tertiary medical center with the following referral questions: "rule-out pericardial effusion" (n = 40) and "rule-out source of embolus" (n = 132). Specific limited echo imaging protocols were formulated without unnecessary imaging (that is, unrelated to the diagnostic question) or use of Doppler. The percentage of full echo studies with significant incidental findings was determined, categorized by patient age, and then recalculated by whether the specific limited imaging protocol could potentially detect any or all of the incidental findings. The percentage of cases with significant incidental findings was 45% and 36% in the "rule-out" pericardial effusion and source of embolus groups, respectively. This percentage was dependent on age <65 years versus > or =65 years (22% vs 42%, p < 0.005). Limited imaging protocols could identify > or =85% of cases with significant incidental findings. These data suggest that limited echo imaging may be feasible in certain patient groups and referral diagnoses.