Ecocardiografia POCUS nella Cardiologia Pediatrica territoriale: esperienza pilota e impatto organizzativo

Background. Paediatric heart disease is a diagnostic challenge for primary care paediatricians who, lacking advanced diagnostic tools, may resort to excessive precautionary hospital referrals. Objectives. To describe the experience of a first-level community paediatric cardiology clinic using point-of-care ultrasound (POCUS) as a diagnostic filter between primary care and a tertiary referral centre. Materials and Methods. A prospective study was conducted over six months (January–June 2025), including 143 children (mean age 4.6\u00b13.8 years) referred by 15 previously trained primary care paediatricians. Main referral reasons included heart murmurs, ECG abnormalities, symptoms suggestive of heart disease and family history of cardiovascular disease or arrhythmias. All patients underwent clinical evaluation and basic cardiac POCUS. Results. Minor echocardiographic abnormalities were identified in 33 patients (23%), mainly small muscular ventricular septal defects, patent foramen ovale and mild valvular abnormalities, all managed with appropriate follow-up. Organisational impact was assessed by comparison with first outpatient visits delivered by the Paediatric Cardiology Unit of the G. Gaslini Institute, which performed 370 comparable visits during the period. The 143 community evaluations represented 38.6% of that volume, corresponding to nearly three months of hospital outpatient activity. A parallel hospital waiting-list reduction programme performed 167 first visits over five months, more than half for non-urgent conditions potentially manageable at community level. Conclusions. The model appears to improve referral appropriateness and reduce the burden on tertiary care centres, representing a potential organisational strategy to optimise paediatric cardiology diagnostic pathways.