Routinely Performed Echocardiography and its Impact on Everyday Clinical Practice in Patients admitted to an Internal Medicine Ward

Objectives: The aim of this study was to evaluate the frequency of significant heart abnormalities detected by routinely applied echocardiography in patients hospitalized in the internal medicine ward due to any medical disease and assess its impact on everyday clinical practice. Methods: Transthoracic Echocardiography (TTE) examinations were performed routinely in a cohort of 2756 patients admitted to the internal medicine ward. Demographic and clinical variables were collected retrospectively. Results: A total of 2756 patients (48.1%; n=1201 females) with a mean age of 76.3 ± 4.3 years were enrolled in the study. Almost half of the patients (41.8%; n=1153) showed significant heart pathology: Left Ventricular Ejection Fraction (LVEF) <50%, at least moderate valvular defect, Right Ventricular Systolic Pressure (RVSP) >36 mmHg, or pericardial effusion, which required further diagnosis and/or therapy. LVEF<50% was observed in 15.5% (n=428) of patients, including 31 (1.1%) patients with extremely low LVEF (<20%). A total of 10.7% of patients (n=295) had severe valvular pathology. Elevated estimated RVSP was observed in 1 out of 6 patients (15.9%, n=446) including 6.9% (n=189) with RVSP >50 mmHg. RVSP >50 mmHg was associated with lung disease (49.2%, n =87), left heart disease (29.6%, n=56), and pulmonary embolism (7.3%, n=13). In the examined group, 28.3% (n=781) of patients required specialist consultation and 10.7% (n=295) were considered as candidates for surgery. Conclusion: TTE is an essential non-invasive tool to evaluate heart structure and function. Routinely performed echocardiography has a significant impact on the decision-making process or treatment in almost half of the patients admitted to the internal medicine ward.