E. Wako, M.D., G. Van Norman, M.D., G.A. Rooke, MD., Ph.D.
Ultrasound technology is used by many specialties in medicine including cardiology, anesthesiology, critical care, surgery, emergency and acute care (1). Device improvements in image capability and quality with a simultaneous reduction in size have made bedside application of ultrasound technology feasible and cost effective. Examples of new applications include the evaluation of intensive care unit and trauma patents, where it has provided valuable information to direct patient care. As one author states "hand-held ultrasound will rival current machines in capabilities and make it possible for transthoracic echo (TTE) to become the stethoscope of the future" (2). The newest application of TTE by Coweie in Australia looked at the use of TTE by cardiac anesthesiologist in the perioperative period (either per-op or post-op). He showed that they were able to perform a successful and accurate exam that altered patient management in 84% of patients studied. To date, there have been no studies looking at role of TTE in the perioperative clinic setting. Our study will investigate whether a general anesthesiologist can be trained to perform a basic TTE, accurately characterizing four specific cardiac findings that are known to affect preoperative decision making (mitral regurgitation, aortic stenosis, pericardial effusion and severe left ventricular dysfunction) in the preanesthesia clinic.