• J Emerg Med · Mar 2022

    Review

    Point-of-Care Ultrasound in the Evaluation of Patients with Left Ventricular Assist Devices at the Emergency Department.

    • Jen Heng Pek and Loon Yee Louis Teo.
    • Department of Emergency Medicine, Sengkang General Hospital, Singapore.
    • J Emerg Med. 2022 Mar 1; 62 (3): 348-355.

    BackgroundLeft ventricular assist devices (LVADs) can be used as a bridging therapy for myocardial recovery or cardiac transplant, as well as a destination therapy for long-term support in patients with advanced heart failure. Patients with LVADs can present to the emergency department (ED) for acute deterioration and emergency physicians (EPs) must be equipped with the necessary knowledge and skill to treat this unique population.ObjectiveThis review describes the role of point-of-care ultrasound (POCUS) in the evaluation of patients with LVADs and illustrates how EPs can incorporate POCUS into the evaluation of these patients in the ED.DiscussionThe clinical applications for which POCUS may be useful in patients with LVADs include hypotension or shock, dyspnea, cardiac failure, dysrhythmia, syncope, and cardiac arrest. The normal features of POCUS in patients with LVADs and the features of POCUS associated with diseased states are presented.ConclusionsPatients with LVADs have altered anatomy and physiology. Therefore, an understanding of key modifications to standard POCUS views is necessary so that EPs can use POCUS effectively in their evaluation of these patients.Copyright © 2021 Elsevier Ltd. All rights reserved.

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