Abstract
BACKGROUND: Primary healthcare centers (PHC) play a pivotal role in the first-line management of patients with diabetes and hypertension, major risk factors for heart failure (HF) development. Point-of-care cardiac ultrasound (POCUS), integrated as an extension of the physical examination, holds significant potential to enhance diagnostic accuracy and clinical management in this setting. OBJECTIVES: Evaluate the impact of POCUS on clinical decision-making in patients with HF and at risk of developing HF in PHC and compare POCUS findings with clinical assessment alone, conventional echocardiography, and electrocardiogram results. METHODS: Patients with diabetes, hypertension, or HF symptoms at a PHC underwent POCUS by a trained family physician. The findings were compared with traditional clinical practice. Decisions regarding referral for an echocardiogram or hospital consultation were contrasted with those of two clinicians who do not use POCUS, and the investigator's echocardiographic results were compared with those from conventional echocardiography and electrocardiogram. Data were analyzed using SPSS. RESULTS: Among 196 patients (66 ± 15 years; 53.6% female), 36.2% had HF symptoms, 89.2% hypertension, and 29.7% diabetes. Investigator requested less echocardiograms (44 vs. 145 and 125) and made less hospital referral (15 vs. 16 and 24). Using POCUS, congestive patients were less than expected (18 vs. 43 cases), and stage B HF patients were more than clinically (44.9% vs. 19.4%). POCUS identified more cases with left ventricular hypertrophy than electrocardiograms (58 vs. 10). CONCLUSION: These findings highlight the value of integrating POCUS into routine family physician consultations, particularly for the management of HF and effective risk stratification.