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J Korean Soc Emerg Med > Volume 31(6); 2020 > Article
Journal of The Korean Society of Emergency Medicine 2020;31(6): 553-561.
응급실에 내원한 급성 관상동맥 증후군이 의심되는 환자들에게 응급의학과 의사가 시행한 경흉부 심초음파의 효용성
김상명 , 정창환
가톨릭관동대학교 국제성모병원 응급의학과
Efficacy of transthoracic echocardiography performed by emergency physician in patients with suspected acute coronary syndrome in the emergency department
Sang Myeong Kim , Chang-Whan Jung
Department of Emergency Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Korea
Correspondence  Chang-Whan Jung ,Tel: 032-290-3065, Fax: 032-290-2886, Email: 8hal10jung@hanmail.net,
Received: September 5, 2019; Revised: November 29, 2019   Accepted: June 23, 2020.  Published online: December 30, 2020.
ABSTRACT
Objective:
This study examined the efficacy of trans-thoracic echocardiography (TTE) performed by emergency physicians in the diagnosis and treatment of acute myocardial infarction (MI) in patients with suspected acute coronary syndrome (ACS).
Method:
This study enrolled patients with suspected symptoms of ACS from January 1, 2017, to June 30, 2017, in the emergency department (ED). One hundred and eighteen patients, who underwent TTE (TTE group), and 384 patients, who did not undergo TTE (control group), were enrolled in this study. The rate of performed coronary angiography (CAG) and percutaneous coronary intervention (PCI) were analyzed in the TTE group. The primary outcomes included the rate of CAG and PCI performed and door-to-puncture time (DTPT).
Results:
The rates of CAG and PCI were significantly higher in the TTE group than in the control group (CAG: 38% vs. 28%, P=0.039; PCI: 31% vs. 21%, P=0.034). The mean DTPT in non-ST segment elevation was 110 minutes (110.2±38.86 minutes) in the TTE group and 151 min (151.3±108.01 minutes) in the control group (P=0.054).
Conclusion:
Patients with suspected ACS in ED with TTE had a higher rate of CAG and PCI performed compared to the patients without TTE. In patients with non-ST segment elevation in the initial electrocardiogram, TTE performed by emergency physicians tended to shorten the time to diagnose MI and DTPT.
Key words: Echocardiography; Acute coronary syndrome; Door to puncture time
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