Evaluation of the effectiveness of transtoracic echocardiography and ultrasound (EKO-US) in exclusion of pulmonary embolism in emergency department

Objective: Pulmonary embolism (PE) is a common cardiopulmonary emergency with a mortality of 30% if left untreated, but decreases to 2-8% if treated appropriately. In this study, the efficacy of ECHO-US in exclusion of Pulmonary Embolism and the power of ECHO-US in diagnosing pulmonary embolism in patients with suspected pulmonary embolism were investigated. Method: The patients included in our study were evaluated at the bedside with the ultrasound of the emergency department, and double-blindly with the researcher and cardiologist who took the basic and advanced USG course by us. 52 patients were included in the study. Statistical analysis of the data was made in IBM SPSS Statics Version 26 program. The compatibility of the variables with the ECHO findings was evaluated with Kappa agreement analysis. ROC analysis was used to estimate the predictive power of pulmonary CT Angio positivity, and p˂0.05 was considered statistically significant. Results: 50% of the cases included in the study were male and 50% were female. When the distribution of the type of embolism was analyzed in those diagnosed with pulmonary embolism, 30% of those diagnosed with pulmonary embolism (n=20) were lobar (n=6); 30% were segmental (n=6); It was found to be 5%. When the distribution of ECG, current ECO, CUS and CT findings of the cases according to the diagnosis of PE is examined; A statistically significant difference was found between the groups in terms of tricuspid regurgitation jet flow velocity elevation, RV/LV (PSSA), RV/LV (A4), D-shape, McConnel, DVT (CUS) and CT RV/LV (PSSA) findings (p ˂0.05). When the ROC analysis results are examined; Cutoff values calculated for Wells and Geneva scores; AUC values calculated for PE diagnosis power of tricuspid regurgitation jet flow velocity elevation, RV/LV (PSSA), D-Shape, McConnel findings and CT RV/LV ratio findings in current ECHO were found to be statistically significant (p<0.05). Conclusion: In the results of our study, in patients diagnosed with Pulmonary Embolism; It has been found that echocardiography is easily available and can help diagnose PE by demonstrating right ventricular (RV) dysfunction. It shows that bedside echocardiography can help emergency physicians make decisions more quickly in pulmonary embolism by increasing the provider's index of suspicion. Keywords: Pulmonary embolism, Echocardiography, Emergency Medicine, USG