A fina linha que divide a teimosia da falta de bom senso...

Stress echocardiography in the district hospital setting: a cost-saving analysis
Nicolai Wennike1, Benoy Nalin Shah2, Emma Boger2, Roxy Senior3 and Kim Greaves
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European Journal of Echocardiography. Volume 11, Issue 5Pp. 401-405.
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The cost saving of stress echocardiography, an accuracy analysis, and adverse outcomes at 6 and 24 months follow-up were determined. The total cost attributable to the stress echocardiography service was £58 368. If unavailable, 78 (39%) patients would have been referred for angiography and 122 (61%) for perfusion scintigraphy at a cost of £56 316 and £42 090, respectively, with a total cost of £98 406. This represents a cost saving of £40 038.

Conclusion Stress echocardiography is a cost saving method for the investigation of chest pain in patients with low–intermediate risk of flow limiting coronary artery disease in the district hospital setting.
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In the case of exercise stress echocardiography, BRUCE protocol symptom-limited treadmill exercise testing was performed with images acquired immediately (within 90 s) after peak exercise. Early post-exercise images with the best endocardial definition were displayed alongside the corresponding baseline images. In patients in whom exercise testing was deemed not possible, dobutamine was infused peripherally in 3 min dose increments, starting from 10 µg/kg/min and increased to 20, 30, and 40 µg/kg/min.
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Estudo mostra que o Ecostress é uma ferramenta eficiente e viável, na análise da dor torácica.
Sempre que possível, com o esforço.
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É barato, rápido e seguro. Mas isso não basta para convencer certos serviços de cardiologia que insistem no ecostress farmacológico ou na cintilografia...
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