Hand-held ultrasound devices (HHUD) provide real opportunity to perform echocardiography at bedside, overcoming the problems imposed by the cumbersome standard equipment. However, the studies at bedside are usually more technically difficult and thus may be more frequently not interpretable.

Objective: To determine the rate of technically difficult studies performed on HHUD. Full-featured echocardiography systems used as a reference.

Methods: We analyzed 4566 echo reports with pointer to the acoustic quality, to the used ultrasound device and to the place of the investigation. With expert-class echo machine were examined 3117 pts, with a standard echo machine - 787 pts, and with a HHUD - 662 pts. We analyzed the rate of technically difficult studies at different ultrasound machines and at different place: at echo lab or at bedside.

Results: 1215 (26.6 %) reports evaluated as technically difficult, but interpretable. Only 13 studies were not interpretable at all. The rate of technically difficult studies increased significantly from expert-class echo machine (22 %) to the standard echo machine (33 %) and to the HHUD (39 %). In comparison with echo lab the rate of technically difficult studies was more frequently at bedside on expert-class echo machine (17.5 % vs 39.1 %, p < 0.001) and on the standard echo machine (22.7 % vs 37.7 %, p < 0.001). The main part of echo studies on HHUD performed at bedside (86 %). At bedside, the rate of technically difficult studies did not different significantly on HHUD (39.9 %), on the standard echo machine (37.7 %) and on expert-class echo machine (39.1 %).

Conclusion: At bedside the rate of technically difficult echo studies is compare on HHUD with expert echo machine and with a standard echo machine.