This year’s conference is going to be different to any I have ever ‘attended’. With the world going topsy turvey, new approaches have emerged that have revolutionised the conference game. The online format is exciting, I can attend more sessions that I ever could in real life. I can sit in comfort and stream knowledge direct to my brain while enjoying a glass of wine, or a cuppa (depending on the time of day). I can benefit from the collective years of expertise from the fantastic line up of speakers and I can still participate fully with the live Q&A sessions. What is more, there are extra pre-recorded sessions that can be viewed at any point in the time limit. Got half an hour while you wait for dinner to cook, watch a session on cardio-oncology. Taking a bath and need something to relax to, then how about a session on routes in to research. Even the real life benefits of meeting old friends, making new ones and networking has been taken care of with the real time chat and forums. This promises to be an exciting conference.
In particular I am looking forward to the sessions on clinical and echocardiographic correlates. Last year I presented in this section and found the research I had to do fascinating. As a physiologist, historically we have not been involved in the clinical history or management. It used to be that we just did the echo and passed on the result. But now, more and more, we are discovering opportunities to use our knowledge and apply it in a broader fashion.
| Talk |
Speaker |
| The patient with palpitations |
Waheed Akhtar |
| The patient with swollen ankles |
Kate Gatenby |
| The patient with chest pain |
Martin Stout |
I work in community echo. The echo may well be the first diagnostic test that my patients have. They have not been evaluated by a cardiologist. Their referral is from their GP and the vast majority of these patients in the community present with one or all of these three symptoms – palpitations, swollen ankles and chest pains. The onward management of these patients is usually determined by the echo result. Knowing what to look for and how to interpret the echo findings in the context of the clinical picture is vital.
Case example: I had a patient referred with a history of with peripheral oedema to the calfs, dyspnoea and AF. His echo clearly showed severe biventricular dysfunction, severe mitral and tricuspid regurgitation and an AF rate 110bpm. Not an unusual presentation I’d say and something that is seen daily in hospital departments. But out in the community when this occurs, it falls to the physiologist to make the decision for immediate further actions
- Do I let this patient go home with instructions to call their GP in the morning?
- Do I send this patient direct to the ED?
- Do I call the GP, discuss the patient and follow their advice?
Without extra knowledge this decision is difficult to make. Other information such as medication, further symptoms, BP and O2 sats is needed.
The patient reported the oedema had reached the top of his thighs despite 80mg of Furosemide for 1 week. His BP was 108/59 mmHg and his SATS were 94% on air.
This information was vital to have at hand when discussing a course of action with the GP on the phone and then making and informed decision to send the patient to the local hospital via the Immediate assessment unit rather than the ED to reduce his exposure to Covid-19.
All of this illustrates the broader role that physiologists now perform. Further training and understanding of the clinical correlates of the echoes we perform is vital to the development of our roles and the service we provide to the patient.
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