Images were acquired by a cardiac ultrasound unit (Hewlett-Packard 77020A) with a 2.5- or 3.5-MHz phased array transducer. Cardiac chamber dimensions and wall thickness were determined quantitatively from two-dimensional directed M-mode echocardiograms and qualitatively from standard parasternal, apical, and subcostal two-dimensional images, and they were described as normal or increased. Left and right ventricular systolic function were estimated visually and described as normal, mildly depressed, or moderately to severely depressed. Wall motion abnormalities corresponding to the anatomic distribution of one or more coronary arteries were described as segmental. Valvular heart disease was reported if visualized valve leaflets were unusually echodense and manifested decreased motion. Pericardial effusions, if present, were reported as small, moderate, or large. A pericardial effusion associated with right atrial or right ventricular diastolic collapse was interpreted as consistent with cardiac tamponade.”’ All echocardiograms were interpreted by one of three cardiologists who neither knew nor participated in the care of the patients.
The interpretation of cardiac echo findings was verbally reported to the primary physicians for each patient immediately after completion of the test. No recommendations either for additional diagnostic studies or for treatment were transmitted. If ordered for clinical purposes, obtainment of additional echocardiograms was not discouraged. Buy Asthma Inhalers Online