Bedside Echocardiography in Thoracic Aortic Syndrome in the Emergency Department (BEaT-ED)

Project Overview

While bedside ultrasound of the heart and aorta, known as transthoracic echocardiography (TTE), has the potential to support early diagnosis of Acute Aortic Syndromes (AAS), there is currently no national standard for how and when it should be used in suspected cases of AAS. A recent systematic review by Dr Nick Mani and his team has revealed major inconsistencies in the use of TTE and highlighted the urgent need to integrate this tool more effectively into clinical pathways alongside decision tools and biomarkers.

Improvement in diagnostic pathway of AAS is one of the James Lind Alliance top 10 priorities for research in emergency medicine.

This study aims to assess current TTE use across UK emergency departments and build expert consensus on best practice, including the role, timing, and selectiveness of bedside ultrasound in diagnosing AAS. In parallel, the research will explore how TTE can help rule in or rule out other serious conditions such as pulmonary embolism or heart attack, helping clinicians distinguish between similar emergencies with greater confidence and speed.

Key strategies include a national survey of emergency departments, followed by a Delphi process with clinical experts to agree on a standardised protocol. Public and Patient Involvement (PPI) will be central throughout. The ultimate goal is to improve diagnostic accuracy and safety, inform NHS training and education, and lay the groundwork for further research into enhanced emergency care for patients with suspected AAS.