Hot Off the Press: SGEM #276—FOCUS on PE in Patients With Abnormal Vital Signs

Focused cardiac ultrasound (FOCUS) has been studied as an option for rapid, bedside diagnosis of pulmonary embolism (PE) with disappointing results when applied to patients with stable vital signs.1 However, in patients with an elevated heart rate (HR), signs of right ventricular dysfunction due to PE are more prevalent.2 Among signs of right ventricular dysfunction (RVD), tricuspid annular plane systolic excursion (TAPSE), which assesses for RVD using M‐mode to measure movement of the tricuspid annulus over the course of a contraction, has been shown to have a higher sensitivity for PE than other signs, particularly in patients with unstable vital signs.2, 3 In this study, the authors sought to investigate the test characteristics of FOCUS in patients with tachycardia and/or hypotension.