P.067 Focused, bedside cardiac ultrasound in stroke: a feasibility study

Abstract

Background: Canadian Stroke Best Practice Recommendations recommend both cardiac monitoring and transthoracic echocardiography (TTE) to assess for cardioembolic sources of stroke. TTE has a diagnostic yield, which is historically low at 5-10%. The goal of this project was to evaluate the practicality of a bedside, focused approach to TTE in ischemic stroke. Methods: A cross-sectional study evaluating patients undergoing echocardiography for evidence of possible cardioembolic stroke was developed. It compared the standard and focused TTE imaging approaches. Of the 61 patients reported, data is currently available for 15 participants. Independent samples t-test were performed to compare measurements. Results: Mean time to finish image acquisition for the focused, bedside TTE was significantly shorter than the complete TTE (12 min or less vs 30 min or more) (p<0.0001). No cardiac sources of stroke were found by either mechanism in this cohort, representing 100% agreement between the two modalities. Conclusions: Focused, bedside echocardiography studies are quicker to execute and employ more affordable, portable, digital TTE devices. The test is done at bedside, reducing the need for patient transport. Image acquisition takes approximately half the time to obtain, potentially allowing for more rapid clinical decision making and facilitation of discharge from hospital.