Focused Cardiac Ultrasound for the Evaluation of Heart Valve Disease in Resource-Limited Settings

AbstractPurpose of reviewsThere are many places in the world where comprehensive echocardiography is not available, including remote or rural regions of high-income countries and outside urban centers of low- to middle-income countries. In this review, we discuss the use case for focused cardiac ultrasound (FoCUS) in remote and low-resource settings including its use by non-expert providers as well as its accuracy and limitations in the assessment of the most common heart valve lesions.Recent findingsFoCUS requires a different workflow compared to comprehensive echocardiography including a system for remote review and reporting by experts who are usually not on site. Multiple approaches used to train novice users to acquire limited FoCUS views, including protocols placing high importance on the parasternal long-axis view, have demonstrated success. Many approaches focus on rheumatic heart disease (RHD) screening and evaluation given its high worldwide prevalence. Models of task-shifting, cloud-based storage, and telemedicine will make diagnosis of heart valve disease more accessible in resource-limited settings.SummaryFoCUS has been increasingly studied as a useful tool to screen for RHD and assess for valve disease in low-resource settings. However, FoCUS is limited in the full evaluation of valvular lesions and requires remote or local expert support, and patient transfer may be necessary for  comprehensive echocardiography when appropriate.
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research