Can Emergency Medicine Residents Diagnose Neurogenic Stunned Myocardium in the Emergency Department by Focused Assessment Diagnostic Echocardiography?

Can Emergency Medicine Residents Diagnose Neurogenic Stunned Myocardium in the Emergency Department by Focused Assessment Diagnostic Echocardiography?

Karimialavijeh E^{1, 2} ; Zarrabi A^{1, 2} ; Akbari H^{1, 2} ; Aghili M^{1, 2} ; Vahidi E^{1, 2} ; Rasooli F^{1, 2}

Show Affiliations

1. Tehran University of Medical Sciences, Tehran, Iran
2. Hospital and Prehospital Emergency Research Center, Tehran, Iran

Source: Critical Care and Shock Published:2020

Abstract

Purpose: To assess the ability of trained emergency medicine (EM) residents to diagnose neurogenic stunned myocardium (NSM) in patients with acute intracranial events in the emergency department (ED) using the Focused Assessment diagnostic Echocardiography (FADE). Methods: This prospective cross-sectional study was conducted between February 2018 and January 2019. First, four postgraduate year-3 (PGY-3) EM residents were trained through participation in 10 hours of theoretical FADE education and 20 hands-on FADE on ED patients. Then, adult patients (aged over 18 years old) with acute cerebrovascular accidents (CVAs) were enrolled in the study. Patients with a history of prior cardiac disease, concurrent CVA and ST-elevation myocardial infarction (STEMI), and cardiopulmonary arrest in the ED were excluded. The results of echocardiog raphy by the cardiologists were considered as the gold standard. Results: Eighty-five cases were enrolled in the final analysis. The mean age of participants was 62.7 years, and 47 (55.3%) were male. There was a good agreement between the EM residents and cardiologists in diagnosing left ventricular (LV) dysfunction (Cohen’s Kappa=0.7, 95%CI=0.65-0.8). Troponin I was positive in 3 (3.5%) patients. Based on the diagnosis of cardiologists, all three patients had heart failure and received a definitive diagnosis of NSM. Whereas, according to the FADE exam by EM residents, 2 out of 3 cases with positive enzyme had heart failure (interrater agreement=66.6%). Conclusion: Our study showed that trained EM residents could use the FADE exam to diagnose the NSM in CVA patients in the ED. © 2020, The Indonesian Foundation of Critical Care Medicine. All rights reserved.

Style	Citing Format
MLA	Karimialavijeh E, et al.. "Can Emergency Medicine Residents Diagnose Neurogenic Stunned Myocardium in the Emergency Department by Focused Assessment Diagnostic Echocardiography?." Critical Care and Shock, vol. 23, no. 2, 2020, pp. 76-84.
APA	Karimialavijeh E, Zarrabi A, Akbari H, Aghili M, Vahidi E, Rasooli F (2020). Can Emergency Medicine Residents Diagnose Neurogenic Stunned Myocardium in the Emergency Department by Focused Assessment Diagnostic Echocardiography?. Critical Care and Shock, 23(2), 76-84.
Chicago	Karimialavijeh E, Zarrabi A, Akbari H, Aghili M, Vahidi E, Rasooli F. "Can Emergency Medicine Residents Diagnose Neurogenic Stunned Myocardium in the Emergency Department by Focused Assessment Diagnostic Echocardiography?." Critical Care and Shock 23, no. 2 (2020): 76-84.
Harvard	Karimialavijeh E et al. (2020) 'Can Emergency Medicine Residents Diagnose Neurogenic Stunned Myocardium in the Emergency Department by Focused Assessment Diagnostic Echocardiography?', Critical Care and Shock, 23(2), pp. 76-84.
Vancouver	Karimialavijeh E, Zarrabi A, Akbari H, Aghili M, Vahidi E, Rasooli F. Can Emergency Medicine Residents Diagnose Neurogenic Stunned Myocardium in the Emergency Department by Focused Assessment Diagnostic Echocardiography?. Critical Care and Shock. 2020;23(2):76-84.
BibTex	@article{ author = {Karimialavijeh E and Zarrabi A and Akbari H and Aghili M and Vahidi E and Rasooli F}, title = {Can Emergency Medicine Residents Diagnose Neurogenic Stunned Myocardium in the Emergency Department by Focused Assessment Diagnostic Echocardiography?}, journal = {Critical Care and Shock}, volume = {23}, number = {2}, pages = {76-84}, year = {2020} }
RIS	TY - JOUR AU - Karimialavijeh E AU - Zarrabi A AU - Akbari H AU - Aghili M AU - Vahidi E AU - Rasooli F TI - Can Emergency Medicine Residents Diagnose Neurogenic Stunned Myocardium in the Emergency Department by Focused Assessment Diagnostic Echocardiography? JO - Critical Care and Shock VL - 23 IS - 2 SP - 76 EP - 84 PY - 2020 ER -

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