Manual on emergency echocardiography from the perspective of cardiologists, acute and emergency physicians—Update 2024

Abstract

In emergency cases rapid echocardiographic diagnostics are of central importance to detect or rule out cardiac disease and the associated possibility of rapid initiation of treatment. In cardiovascular emergencies not only echocardiographic findings but also sonographic findings of the lungs and large vessels should be obtained. In addition to the existing recommendations on emergency echocardiography from 2013, this update is less a new edition of the previous content than a focus on current aspects. Echocardiographic imaging of the essential cardiac structures and their function continue to form the basis of emergency echocardiography. These cardiac structures should be captured in representative image sequences which, however, do not have to be standardized due to the exceptional situation. Areas of application of echocardiography in pericardial effusion including pericardial puncture, contusio cordis and cardiac replacement systems are discussed in detail due to their increasing importance, with a particular focus on hygiene measures and the use of modern echocardiographic methods in emergency situations. Furthermore, portable ultrasound devices fundamentally enrich echocardiographic emergency diagnostics, even if they are limited in terms of documentation and storage modalities. Ultimately, emergency echocardiography also requires a report that should include a description of the cardiac conditions as well as information on the examiner and equipment, time and location and basic data on the patient. In order to improve emergency echocardiography in general, time must be allowed for thorough training.