Heartbeat: Telemedicine for echocardiography screening

Echocardiography allows accurate, rapid, non-invasive diagnosis of heart disease but is not available in many underserved populations. Nascimento and colleagues1 in Brazil tested the hypothesis that telemedicine interpretation of a focused handheld echo study performed by a healthcare provider with condensed imaging training could improve delivery of cardiovascular care to patients in low-resource areas. Remarkably, echo screening of 299 asymptomatic primary care patients identified significant heart disease in 35%, with a higher prevalence of disease in older patients (figure 1). Comparing screened patients to the 705 patients specifically referred for echocardiography based on clinical symptoms or signs, moderate-severe left ventricular systolic dysfunction was observed in 4.1% vs 8.1% (P=0.03), mitral regurgitation in 8.9% vs 20.3% (P<0.001) and aortic stenosis in 5.4% vs 4.3% (P=0.51). Prevalence of echo-diagnosed heart disease was highest in those over age 65 years. Figure 1 Echocardiographic prevalence of major heart disease requiring priority referral based on the final conclusion of the expert readers, according to study group. AV, aortic valve; MV, mitral valve; LV, left ventricle. Peters and Patil2 comment that “Cardiac point-of-care ultrasound (POCUS) has been rapidly adopted across a variety of practice settings. The popularity stems from the ability to rapidly assimilate findings at …