Thanks to the widespread commercial availability of handheld probes, point of care ultrasound (POCUS) shows promise as a valuable tool for quick and efficient bedside assessment for several cardiovascular conditions, however, it remains underutilized in mainstream clinical practice. ACC's new POCUS workbook provides pragmatic guidance and best practices for using POCUS in cardiovascular clinical practice.

The workbook highlights the advantages and barriers of POCUS spanning various clinical settings including inpatient units, emergency departments, intensive care units, outpatient visits, long-term facilities and virtual care. It also highlights appropriate triage of cardiovascular patients and addresses when and how to use POCUS for initial cardiac screening, as well as for volume and/or vascular assessments. For example, the workbook notes that goal-directed POCUS can be the one-stop tool for initial screening for structural changes in the cardiac valves and chambers, while volume assessment using POCUS can aid differentiation of cardiogenic from non-cardiogenic causes of dyspnea. Use of POCUS for vascular assessment can help target the aorta, deep veins and peripheral blood vessels.

Additionally, the workbook addresses the rapid rise of artificial intelligence (AI), which gained prominence during the COVID pandemic as part of telehealth. "Tele-POCUS" allowed for the use of POCUS remotely through AI-driven guidance or direct supervision. The workbook also highlights opportunities to further enhance the quality of image acquisition and interpretation by using AI, remote learning and guidance, web-based operations, and other technology.

According to Partho P. Sengupta, MD, FACC, the POCUS innovation workbook chair, numerous studies have shown that, regardless of the operator's level of experience, the direct visual assessment using cardiovascular POCUS is superior to cardiovascular auscultation for detecting cardiovascular diseases during routine bedside cardiovascular examination. "The ACC POCUS workbook provides a fantastic overview of how standardized approaches in using miniaturized cardiac ultrasound devices can aid immediate detection of cardiovascular pathologies for high-quality and high-impact clinical decision-making," he says.

Download the workbook here.

Clinical Topics: COVID-19 Hub, Heart Failure and Cardiomyopathies

Keywords: Artificial Intelligence, Dyspnea, Auscultation, Telemedicine, Aorta, COVID-19

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