{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:49:47Z","timestamp":1753876187831,"version":"3.41.2"},"reference-count":7,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,10,22]],"date-time":"2019-10-22T00:00:00Z","timestamp":1571702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Echocardiography has been traditionally performed in echo labs and the potential benefits of its use by primary care physicians (PCPs) are still unexplored. We present a case where POCUS (point-of-care ultrasound) was used as a complement of physical examination by a family doctor, allowing a prompt clinical decision in a heart failure (HF) patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>An 85-year-old woman, living independently, asks her family doctor for a home consultation due to increasing dyspnoea. On examination, severe dyspnoea and bilateral ankle oedema was noted and a point-of-care echocardiogram was performed by the primary care physician, who observed: severely compromised left ventricular systolic function, moderate mitral and tricuspid regurgitation, and severe dilation of the inferior vena cava. As a result, the diagnosis of HF with decreased ejection fraction was formed supporting the therapeutic decision.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case represents an elderly patient with dyspnoea, without previous HF diagnosis. The primary care physician, used portable ultrasound as a complement of physical examination, which confirmed a HF diagnosis, allowing a prompt decision-making on therapy. POCUS, can be a powerful tool to expedite treatment in different settings, including the home consultations by PCPs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytz179","type":"journal-article","created":{"date-parts":[[2019,10,22]],"date-time":"2019-10-22T15:53:08Z","timestamp":1571759588000},"source":"Crossref","is-referenced-by-count":0,"title":["Moving the needle towards the democratization of echocardiography: a case report"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6248-3907","authenticated-orcid":false,"given":"Jonathan","family":"dos Santos","sequence":"first","affiliation":[{"name":"ACeS Baixo T\u00e2mega, UCSP Celorico de Basto, Assento, Britelo, Celorico de Basto, Portugal"},{"name":"Department of Medicine, Faculty of Medicine of Porto University, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6373-7179","authenticated-orcid":false,"given":"Patr\u00edcia","family":"Borges Fernandes","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine of Porto University, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"USF S\u00e3o Miguel Arcanjo, ACeS Vale do Sousa Sul, Rua, Marqu\u00eas de Pombal, 682, 4560-682 Penafiel, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9068-9547","authenticated-orcid":false,"given":"Francisco","family":"Rocha Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine of Porto University, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9030-3686","authenticated-orcid":false,"given":"Alexandra","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine of Porto University, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]}],"member":"286","published-online":{"date-parts":[[2019,10,22]]},"reference":[{"key":"2019102210092078800_ytz179-B1","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J"},{"key":"2019102210092078800_ytz179-B2","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1001\/jamacardio.2018.0001","article-title":"Time to add a fifth pillar to bedside physical examination: inspection, palpation, percussion, auscultation, and insonation","volume":"3","author":"Narula","year":"2018","journal-title":"JAMA Cardiol"},{"key":"2019102210092078800_ytz179-B3","doi-asserted-by":"crossref","first-page":"52.","DOI":"10.1186\/s13049-015-0122-2","article-title":"Does physician experience influence the interpretability of focused echocardiography images performed by a pocket device?","volume":"23","author":"Bobbia","year":"2015","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"2019102210092078800_ytz179-B4","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1136\/heartjnl-2016-309915","article-title":"Point-of-care cardiac ultrasound techniques in the physical examination: better at the bedside","volume":"103","author":"Kimura","year":"2017","journal-title":"Heart"},{"key":"2019102210092078800_ytz179-B5","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/S2213-2600(14)70135-3","article-title":"Point-of-care ultrasonography in patients admitted with respiratory symptoms: a single-blind, randomised controlled trial","volume":"2","author":"Laursen","year":"2014","journal-title":"Lancet Respir Med"},{"key":"2019102210092078800_ytz179-B6","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1016\/j.chest.2017.02.003","article-title":"Point-of-care ultrasonography for evaluation of acute dyspnoea in the ED","volume":"151","author":"Zanobetti","year":"2017","journal-title":"Chest"},{"key":"2019102210092078800_ytz179-B7","first-page":"432","article-title":"Extended heart failure clinic follow-up in low-risk patients: a randomized clinical trial (NorthStar)","volume":"34","author":"Schou","year":"2013","journal-title":"Eur\u00a0Heart\u00a0J"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytz179\/30259802\/ytz179.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytz179\/30259802\/ytz179.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,10,22]],"date-time":"2019-10-22T15:53:13Z","timestamp":1571759593000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article\/doi\/10.1093\/ehjcr\/ytz179\/5602560"}},"subtitle":[],"editor":[{"given":"Nikos","family":"Papageorgiou","sequence":"additional","affiliation":[]},{"given":"Georg","family":"Goliasch","sequence":"additional","affiliation":[]},{"given":"Hugo","family":"Rodriguez-Zanella","sequence":"additional","affiliation":[]},{"given":"Anastasia","family":"Vamvakidou","sequence":"additional","affiliation":[]},{"given":"Vishal Shahil","family":"Mehta","sequence":"additional","affiliation":[]}],"short-title":[],"issued":{"date-parts":[[2019,10,22]]},"references-count":7,"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytz179","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published":{"date-parts":[[2019,10,22]]},"article-number":"ytz179"}}