Handheld U/S Beats Physical Exam for Heart Abnormalities
Less downstream testing for patients with no significant abnormality; reduces overall costs
TUESDAY, Oct. 7, 2014 (HealthDay News) -- For patients with suspected cardiac abnormalities, handheld ultrasound (HHU) is more accurate for diagnosis than physical examination, according to a study published online Sept. 17 in JACC: Cardiovascular Imaging.
Manish Mehta, M.D., from Oregon Health & Science University in Portland, and colleagues compared physical examination and HHU in patients referred for a standard echocardiogram for common indications (cardiac function, murmur, stroke, arrhythmias, and miscellaneous). Two hundred-fifty patients underwent physical examination and HHU by different cardiologists.
The researchers found that 142 of the patients had an abnormal finding on standard echocardiogram. HHU and physical examination correctly identified 82 and 47 percent of patients, respectively. For both normal and abnormal cardiac function, HHU was superior to physical examination. In addition, it was superior for correctly identifying the presence of substantial valve disease (71 versus 31 percent) and for identifying miscellaneous findings (47 versus 3 percent). Of the patients without abnormalities on standard echocardiography, further testing was recommended for 82 and 56 percent, respectively, of those undergoing physical examination and HHU. In cost modeling, the average cost was $644.43 for HHU and $707.44 for physical examination, for a savings of $63.01 per patient.
"When used by cardiologists, HHU provides a more accurate diagnosis than physical examination for the majority of common cardiovascular abnormalities," the authors write.
One author disclosed financial ties to the medical device industry.