Medicine of the Future in America

Immediate Echocardiography in the Management of Acute Respiratory Exacerbations of Cardiopulmonary Disease: Results (Part 1)

Patients
Most patients presenting with acute dyspnea were observed to have a history of cardiac or pulmonary disease (89 percent). The clinical features of these patients are summarized in Table 1. Among the 196 patients evaluated, 104 (53 percent) were randomized to receive echocardiograms, and 92 patients (47 percent) were randomized to control. Other than a faster initial heart rate in control than in echo patients, there were no significant differences in the characteristics of patients in the two groups. asthma inhalers

Table 1—Patient Characteristics

Clinical Characteristics

Group

Echo

Control

P

n

104

92

Sex, No. (%)

M

54

55

F

50

37

Age, yr, mean ± SD

(range)

60.7 ±15

62.8 ±17.1

NSD

Medical historv, No.

(%)

Cardiac only

35

33

NSD

Pulmonary only

27

19

NSD

Cardiac and

pulmonary

35

25

NSD

Neither

5

8

NSD

None

2

7

>1

Medication history, No.

(%) *

Cardiac only

39

38

NSD

Pulmonary only

16

15

NSD

Cardiac and

pulmonary

26

16

NSD

Neither

11

8

NSD

None

12

15

NSD

Condition on

admission, No. (%)

Critical (ICU)

16

20

NSD

Admission clinical

findings

Pulse rate, beats/min

93 ±20

103 ±24

<.002

Respiratory rate

24 ±7

24 ±7

NSD

Blood pressure,

mm Hg

132 ± 23/80 ±

13 133 ± 20/79 ±13

NSD

Temperature, °C

37.1 ±0.8

37.1 ±0.9

NSD

Abnormal results of

pulmonary

examination, *

No. (%)

77

79

NSD

Abnormal results of

cardiac

examination^

No. (%)

83

71

NSD

Admission laboratory

findings, No. (%)

Hypoxemia^

23

21

NSD

Abnormal chest

roentgenogram

Cardiomegaly

46

41

NSD

Abnormal lung

39

36

NSD

fields§

Abnormal

elect rocardiogramU

53

51

NSD

*Presence of wheezing, rales, diminished breath sounds, or dullness to percussion.

*Presence of S3 of S4 gallop, murmur, distended neck veins, hepatomegaly, or pretibial edema.

*Room air Po,m air arterial blood gas testing).

*Pulmonary edema, infiltrate, pleural effusion, or roentgeno-graphic findings consistent with chronic lung disease (96 echo and 86 control patients had chest roentgenography).

*Presence of pathologic Q waves or abnormal ST-T segments (85 echo and 76 control patients had electrocardiograms).

Sex, No. (%)

This entry was posted in Cardiopulmonary Disease and tagged Dyspnea, Echocardiography, Pulmonary disease, Valvular heart disease.
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