Effect of Breast Sling Use on Transthoracic Echocardiographic Examination Time and Image Quality in Women with Large Breasts Kesaree Punlee BSc, MM*,**, Wandee Rochanasiri BNS*,**, Vithaya Chaithiraphan MD*, Suteera Phrudprisan BNS*,**, Akarin Nimmannit MD, MSc***, Kamol Udol MD, MSc*,****
* Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Nursing, Siriraj Hospital, Bangkok, Thailand *** Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand **** Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Affiliation :
Background : Transthoracic echocardiographic examinations in women with large breasts are technically demanding and
can lead to suboptimal image quality, excessive scan time, and cause pain and discomfort to patients.
Objective : Evaluate the effects of self-made breast sling used during transthoracic echocardiographic examination on
scanning time, image quality, pain, and satisfaction in women with large breasts.
Material and Method: A self-made breast sling was developed by the study team and tested in 26 women with bra cup size
of C or larger, who were scheduled for transthoracic echocardiography. Each patient underwent transthoracic
echocardiographic examination twice, with and without breast sling use. The sequence of the examinations was determined
at random. The primary outcome was scan time in apical views. Secondary outcomes included total scan time, image quality
in apical views (qualitative scores), patients’ and sonographers’ pain (qualitative scores), and patients’ satisfaction (qualitative
scores). Outcomes were compared within individual subjects.
Results : The use of self-made breast sling did not reduce scan time in apical views (mean difference 2.8 minutes, p = 0.053),
but it reduced total scan time (mean difference 5.9 minutes, p = 0.04). Breast sling use was not associated with improvement
in image quality scores (p = 0.59), patients’ pain (p = 0.21), and sonographers’ shoulder-back-neck pain (p = 0.052).
It improved patients’ satisfaction (p = 0.01) and sonographers’ wrist pain (p = 0.035).
Conclusion : In women with large breasts who required transthoracic echocardiographic examination, the use of self-made
breast sling did not improve scan time and image quality in apical views. It may improve total scan time, patients’ satisfaction,
and sonographers’ wrist pain.
Keywords : Breast sling, Large breast, Transthoracic echocardiography, Scan time, Image quality
