Background: Although point-of-care ultrasound can improve patient care and reduce unnecessary downstream costs, few economic models exist on hospitalist use and whether remuneration for imaging could offset equipment costs.  As the heart and lungs are commonly examined during admission, we observed the frequency of use and projected fiscal outcomes of point-of-care cardiac ultrasound by an [...]

Background: National guidelines recommend sampling unilateral pleural effusions to characterize the fluid as either transudative or exudative.  Currently, the only method to characterize pleural fluid is by collecting a sample through an invasive drainage procedure that has risks of complications and is uncomfortable for the patient.  Few noninvasive methods have been studied to differentiate exudative [...]

Background: Although point-of-care ultrasound can improve patient care and reduce unnecessary downstream costs, few economic models exist on hospitalist use and whether remuneration for imaging could offset equipment costs.  As the heart and lungs are commonly examined during admission, we observed the frequency of use and projected fiscal outcomes of point-of-care cardiac ultrasound by an [...]

Background: New onset third degree or complete heart block (CHB) is a medical emergency and usually requires permanent pacemaker. CHB can be caused by cardiac ischemia or non-ischemic conditions such as infiltrative diseases or fibrosis. The purpose of this study was to analyze the clinical characteristics associated with ischemic versus non ischemic causes of complete [...]

Background: In 2014, the ACC/AHA released guidelines regarding indications for preoperative transthoracic echocardiogram (pre-op TTE) in patients undergoing noncardiac surgery. Studies indicate that the ordering of pre-op TTE in noncardiac surgery is not consistent with the ACC/AHA guidelines. Some studies suggest the pre-op TTE have a significant impact on management, while others have demonstrated low cardiac [...]

Background:  Transthoracic echocardiography (TTE) is one of the most popular tests in healthcare. Studies of Medicare beneficiaries for example have shown that each year approximately 20% undergo at least one TTE. Repeat TTE defined as TTE done within one year of a prior TTE represent 24-42% of all studies. In the present study we derive [...]

Background: Guidelines recommend in-hospital evaluation with cardiac monitoring and transthoracic echocardiogram (TTE) to assess syncope in patients that are considered high-risk for major adverse cardiovascular events. We sought to identify variables associated with performing TTE in patients presenting with syncope. Methods: We abstracted demographic and clinical data from all patients evaluated for syncope at the [...]

Case Presentation: An 85-year-old female with a medical history of hypertension, hyperlipidemia and tobacco abuse presented to the ED with a several day history of intermittent, non-radiating substernal chest pain that occurred at rest. Physical exam revealed normal vital signs, regular cardiac rhythm, no murmurs or gallops, clear lungs, and no jugular venous distention or [...]

Background: Echocardiography is an essential evaluation in the diagnosis of infectious endocarditis (IE). Transthoracic echocardiography (TTE) is a portable study that is widely available and non-invasive. Though transesophageal echocardiography (TEE) is traditionally known for higher sensitivity and specificity, it is speculated that improvements in modern TTE imaging could produce higher diagnostic yield than previously thought. [...]

Background: Unnecessary hospitalizations and testing for syncope remain common (1), and physician attitudes continue to favor overuse for syncope (2). Structured protocols, specialized units, and decision support algorithms may reduce health service use, but lack of data precludes the ability to advocate for use of a specific decision support algorithm (3). Purpose: Our primary aim [...]