Idrisu Sanusi

Acute medicine trainees can chose to pursue a specialist interest as part of their training. I decided to train in echocardiography and I’m currently close to attaining the BSE Adult Transthoracic Echocardiography Accreditation. I have found echocardiography a useful tool to rapidly answer important clinical questions and aid management of the acutely unwell patient. For example, an 85 year old was admitted with acute shortness of breath, hypoxia despite high flow oxygen and a normal CXR. A bedside echocardiogram revealed thrombi in the right atrium with mild right ventricular strain. A CTPA confirmed a saddle embolus and she was admitted to CCU as a precaution in case thrombolysis was required. In another case, a 75 year old was admitted to the emergency department after successful DC cardioversion for VF arrest 10 days post primary PCI for anterior STEMI. The post arrest ECG did not show new acute ischaemia. He had 2 further VT arrests with successful DC cardioverison to sinus rhythm. An echocardiogram revealed an acutely dilated right ventricle and he was thrombolysed for a high risk pulmonary embolus.