Reporting your handheld ECHO findings

26th Nov 2020

Handheld echocardiography (HHE) studies are not complete until a report is made available for the referring team or individual. 

A systematic approach should be used when reporting studies: standardized protocols ensure that key components of the study are clearly described in a structured format for other clinicians. Handheld echocardiography also ensures documentation of the results and allows for comparison with future studies.

In certain cases—particularly in intensive care—a verbal description of the findings may precede a written report. In these situations, clear language is essential to ensure that the results are understood by doctors who are not trained in echocardiography. Phrases such as “severely calcified, functionally bicuspid aortic valve, peak velocity of 5 m/s” can easily be reworded to “severe aortic stenosis”, which will be understood by all clinicians. 


Always consider the terminology you use when describing handheld echocardiography (HHE) findings. The descriptions must be understood by doctors who are not trained in echocardiography. Medmastery note.


In the written report, 11 key components are required to ensure proper documentation of the echocardiography findings: 

  1. Date, time, study location, and name of the operator
  2. Indications of the echocardiogram  
  3. COVID status of the patient (positive, negative, unknown)  
  4. Ventilation status (for intensive care patients)
  5. Description of biventricular size and function 
  6. Presence of regional wall motion abnormalities 
  7. Presence of valve lesions 
  8. Presence of pericardial effusion
  9. Description of inferior vena cava (IVC) size, if applicable (filling status) 
  10. Hemodynamic status (blood pressure, heart rate, and rhythm) 
  11. Patient’s body size (height, weight, and body surface area) 

When possible, measurements should be performed at a workstation to limit exposure time at the patient’s bedside.   

Electrocardiogram (ECG) leads are not typically used in HHE, since they increase the risk of cross-contamination. Heart rate and rhythm can be obtained by reviewing ECG monitors at the time of the study or from previously recorded ECGs. 

Similarly, height and weight measurements can be obtained from admission records away from the bedside. 

Clipboard showing key components for handheld echocardiogram report. Illustration.

Figure 1. Key components for the handheld echocardiography (HHE) written report include the date, time, study location, name of the operator, indications of the echocardiogram, COVID status of the patient, ventilation status, description of biventricular size and function, presence of regional wall abnormalities, presence of valve lesions, presence of pericardial effusion, description of inferior vena cava (IVC) size, hemodynamic status (blood pressure, heart rate, rhythm), and body size (height, weight, body surface area). 


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Recommended reading

  • Chamsi-Pasha, MA, Sengupta, PP, and Zoghbi, WA. 2017. Handheld echocardiography: Current state and future perspectives. Circulation136: 2178–2188. PMID: 29180495
  • Clerkin, KJ, Fried, JA, Raikhelkar, J, et al. 2020. COVID-19 and cardiovascular disease. Circulation141: 1648–1655. PMID: 32200663
  • Doyen, D, Moceri, P, Ducreux, D, et al. 2020. Myocarditis in a patient with COVID-19: A cause of raised troponin and ECG changes. Lancet395: 1516. PMID: 32334650
  • Drake, DH, De Bonis, M, Covella, M, et al. 2020. Echocardiography in pandemic: Front-line perspective, expanding role of ultrasound and ethics of resource allocation. J Am Soc Echocardiogr33: 683–689. PMID: 32503707
  • Fukuhara, S, Rosati, CM, and El-Dalati, S. 2020. Acute type A aortic dissection during the COVID-19 outbreak. Ann Thorac Surg. 110: e405–e407. PMID: 32333849
  • Haji, K, Wong, C, Neil, C, et al. 2019. Handheld ultrasound to reduce requests for inappropriate echocardiogram (HURRIE). Echo Res Pract6: 91–96. PMID: 31516721
  • Hua, A, O’Gallagher, K, Sado, D, et al. 2020. Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19. Eur Heart J41: 2130. PMID: 32227076
  • Johri, AM, Galen, B, Kirkpatrick, JN, et al. 2020. ASE statement on point-of-care ultrasound during the 2019 novel coronavirus pandemic. J Am Soc Echocardiogr33: 670–673. PMID: 32503704
  • Meyer, P, Degrauwe, S, Van Delden, C, et al. 2020. Typical takotsubo syndrome triggered by SARS-CoV-2 infection. Eur Heart J41: 1860. PMID: 32285915
  • Neskovic, AN, Hagendorff, A, Lancellotti, P, et al. 2013. Emergency echocardiography: The European association of cardiovascular imaging recommendations. Eur Heart J Cardiovasc Imaging14: 1–11. PMID: 23239795
  • Nguyen, VTQ, Ho, JE, Ho, CY, et al. 2008. Handheld echocardiography offers rapid assessment of clinical volume status. Am Heart J156: 537–542. PMID: 18760138
  • Poissy, J, Goutay, J, Caplan, M, et al. 2020. Pulmonary embolism in patients with COVID-19: Awareness of an increased prevalence. Circulation142: 184–186. PMID: 32330083
  • Shi, S, Qin, M, Shen, B, et al. 2020. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol5: 802–810. PMID: 32211816
  • The American Society of Echocardiography. ASE statement on protection of patients and echocardiography service providers during the 2019 novel coronavirus outbreak. 2020.  
  • The American Society of Echocardiography. Cleaning recommendations from ultrasound manufacturers. 2020.
  • The Department of Health and Social Care (DHSC), Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS) and Public Health England. COVID-19: Guidance for infection prevention and control in healthcare settings. Version 1.0. 2020. 
  • Zeng, JH, Liu, YX, Yuan, J, et al. 2020. First case of COVID-19 complicated with fulminant myocarditis: A case report and insights. Infection48: 773–777. PMID: 32277408