Infective Endocarditis Diagnosed by Emergency Physicians Using Cardiac
POCUS
: A Case Series
Jonathan Henry, Mark Rugless, Claudiu Radeanu, Abrar Waliuddin, Kevin Phang, Allan Whitehead, Shanu Khader, David Henry, Darsim Haji ABSTRACT
Introduction
Emergency physicians (EPs) are acquiring ever‐increasing expertise in cardiac point‐of‐care ultrasound (POCUS). We compiled this case series to demonstrate current practice by EPs diagnosing infective endocarditis (IE) using POCUS.
Methods
This case series outlines 19 cases of IE diagnosed in the Emergency Department (ED) by Australasian EPs. It is a retrospective review of cases occurring between 2013 and 2022.
Results
Our cohort's characteristics: 84% male, with a mean age of 42, and 79% were people who inject drugs (PWID) intravenously. Left heart valves were affected in 68% of patients, with
Streptococcus viridans
species (37%) and methicillin‐sensitive
Discussion
Echocardiographic diagnosis of IE by EPs is occurring with increasing frequency, and we expect this trend to accelerate further as skillsets and machine image quality improve. Early diagnosis of IE in the ED has high potential to reduce morbidity and mortality in this vulnerable patient group.
Conclusion
Further research is needed to determine the sensitivity and specificity of EP‐performed cardiac POCUS for identification of vegetations.