Presentation Title

Ultrasonographic Measurement of the Right Ventricular Outflow Tract Systolic Excursion to Diagnose Patients with acute Pulmonary Embolism: A Comparison to the Gold Standard

Start Date

November 2016

End Date

November 2016

Location

Surge 172

Type of Presentation

Oral Talk

Abstract

Acute pulmonary embolism (aPE) is a fatal condition that can lead to death if not quickly identified and treated. The current standard of care in patients with suspicion for pulmonary embolism consists of a Computed Tomography scan of the Pulmonary Arteries (CTPA). Despite the accuracy of CTPA, many patients are unable to undergo this test due to renal disease, pregnancy or risk of radiation. Recently, ultrasonography has shown some promise in obtaining the tricuspid annular plane systolic excursion (TAPSE) measurements to help make the diagnosis of aPE. We assessed the right ventricular outflow tract (RVOT) by using cardiac point-of-care ultrasound (POCUS) in the evaluation of patients with suspicion for aPE. We prospectively enrolled patients who presented to the Emergency Department with a clinical suspicion of aPE and were ordered a CTPA between November 2015 and September 2016. This study consists of a comparative analysis of two cohorts of patients based on the results from the gold standard (CTPA scan). We enrolled a total of 41 patients. Of the 41 patients with a suspicion of aPE based on the CTPA scan, 10 patients had an aPE (24.39%) and 31 patients did not have an aPE (75.61%). We performed an un-paired t-test to calculate the significance of TAPSE in identifying patients with aPE. Based on preliminary data, our study shows that there is no statistical significance (p=0.05568) in the identification of patients with pulmonary embolisms; however, there is a trend that supports our hypothesis.

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Nov 12th, 2:30 PM Nov 12th, 2:45 PM

Ultrasonographic Measurement of the Right Ventricular Outflow Tract Systolic Excursion to Diagnose Patients with acute Pulmonary Embolism: A Comparison to the Gold Standard

Surge 172

Acute pulmonary embolism (aPE) is a fatal condition that can lead to death if not quickly identified and treated. The current standard of care in patients with suspicion for pulmonary embolism consists of a Computed Tomography scan of the Pulmonary Arteries (CTPA). Despite the accuracy of CTPA, many patients are unable to undergo this test due to renal disease, pregnancy or risk of radiation. Recently, ultrasonography has shown some promise in obtaining the tricuspid annular plane systolic excursion (TAPSE) measurements to help make the diagnosis of aPE. We assessed the right ventricular outflow tract (RVOT) by using cardiac point-of-care ultrasound (POCUS) in the evaluation of patients with suspicion for aPE. We prospectively enrolled patients who presented to the Emergency Department with a clinical suspicion of aPE and were ordered a CTPA between November 2015 and September 2016. This study consists of a comparative analysis of two cohorts of patients based on the results from the gold standard (CTPA scan). We enrolled a total of 41 patients. Of the 41 patients with a suspicion of aPE based on the CTPA scan, 10 patients had an aPE (24.39%) and 31 patients did not have an aPE (75.61%). We performed an un-paired t-test to calculate the significance of TAPSE in identifying patients with aPE. Based on preliminary data, our study shows that there is no statistical significance (p=0.05568) in the identification of patients with pulmonary embolisms; however, there is a trend that supports our hypothesis.