Diagnostic utility of handheld ultrasonography as an extension of the physical examination of patients with heart failure

Background and objectives: Conventional echocardiography is the technique of choice for assessing left ventricular function and the presence of structural heart disease in patients with heart failure. The aim of this study was to assess the diagnostic performance of handheld ultrasonography performed by a medical internist on patients with a clinical diagnosis of heart failure.

Patients and methods: Cross-sectional observational study of 212 patients diagnosed with heart failure in a hospital center. A medical internist with basic training in echocardiography performed an examination using handheld ultrasonography and semiquantitatively assessed several variables. The patients' left ventricular systolic function was assessed, along with the cavity dimensions, significant valvular heart disease, pericardial effusion and the diameter of the inferior vena cava.

Results: The examination using handheld ultrasonography was conducted in less than 6minutes. The agreement between the diagnoses of the medical internist and the expert echocardiographist was very good (k>0.81) for the diameter, hypertrophy and left ventricular systolic function, valvular regurgitation, pericardial effusion and diameter of the inferior vena cava.

Conclusions: Handheld echocardiography performed by a medical internist, as an extension of the physical examination of patients with heart failure, is a valid and safe test that helps increase the diagnostic performance.