In this thesis we repmi the many evaluation studies with the hand-held ultrasound device in the assessment of different cardiac pathologies and in different clinical settings. The reason for using the tetm "ultrasound stethoscopy" is that these devices are augmenting our physical examination by allowing to visualise the heart and hence extend our physical sense of "seeing". Since stethoscopy stands for "seeing the heart" as previously mentioned, the tenn ultrasound stethoscope seems to be the most appropriate term describing these instruments. One could argue that the introduction of echocardiography at the bedside could weaken the importance of auscultation and the physical examination in particular. However, it was echocardiography that brought out the limitations of physical examination in many cardiac conditions and also exposed human auditory limitations (7-10). Although auscultation entered a modem era with the introduction of electronic stethoscopes (11 ), physicians rely on more sophisticated technology. Inadequate training and time pressure due to increasing work load of patients in combination with the availability of advanced technologies are the reasons of poor auscultatory proficiency seen in recently trained physicians particularly in developed countries (12). Nevertheless, we have to admit that direct observation such as seeing is more accurate for cardiac diagnosis than indirect observation such as hearing. "Seeing" enables the preclinical detection of pathologies and especially pathologies that are beyond physical signs, e.g. small mass lesions. The first reactions from experienced echocardiographers to the ultrasound stethoscope were related to its capabilities/limitations and the training required for physicians who use it (13). The last 2 years refinements in the technology of the ultrasound stethoscopes and addition of modalities like spectral Doppler and M-Mode have improved the diagnostic potentials of these devices. No doubt that training is required to use an imaging device. Recently the American Society of Cardiology (14) published guidelines regarding the use of ultrasound stethoscopes recommending Level I of training (15) as an absolute minimal level required. However, recent studies have shown that it is possible to train physicians and students for the detection of significant pathologies in a short period ( 16,17).
|Keywords||cardiac diagnosis, hand-held ultrasound device, personal ultrasound imagers (PUI), point-of-care echocardiography, ultrasound, ultrasound stethoscopes|
|Promotor||Roelandt, J.R.T.C. (Jos)|
|Publisher||Erasmus MC: University Medical Center Rotterdam|
Vourvouri, E.C.. (2002, November 27). Ultrasound stethoscopy. Erasmus MC: University Medical Center Rotterdam. Retrieved from http://hdl.handle.net/1765/32053