Acute breathlessness is an alarming symptom that frequently calls for an emergent evaluation. Even among patients with known cardiac or pulmonary disease, treatment of dyspnea requires some immediate knowledge or assumption about underlying heart and lung function. Unfortunately, neither physical signs, such as tachypnea, rales, or wheezes, nor laboratory studies, such as electrocardiography, chest roentgenography or arterial blood gases can necessarily distinguish a cardiac from a pulmonary cause of dyspnea. Unless such a cause is readily apparent, the immediate treatment of the patient in respiratory distress may be uncertain, delayed, or even hampered by inappropriately directed treatment measures.
Echocardiography is a well-established diagnostic modality whose ability to rapidly examine heart structure and function has expedited diagnosis in patients with cardiac tamponade, myocardial infarction, and other cardiac conditions. The purpose of this prospective study was to determine whether emergent echocardiography to implicate or exclude a cardiac basis for breathlessness can facilitate the treatment of patients with acute respiratory exacerbations of cardiac or pulmonary disease. buy asthma inhaler