Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Emergency Medicine


Tom Colletti, DHSc, PA-C, DFAAPA


In the US there are more than 6.2 million patients diagnosed with heart failure and the number of cases is expected to continue rising. Acute Decompensated Heart Failure (ADHF) is a common condition with significant morbidity and mortality. Early recognition of the signs and symptoms suggesting ADHF and the subsequent management of this condition are the primary roles of the emergency clinician on duty. Some of the most common symptoms associated include dyspnea, orthopnea, fatigue, weakness, cough and peripheral edema. The purpose of this article is to review the diagnostic accuracy and benefits of lung ultrasound (LUS) for the detection of ADHF in the emergency department (ED) setting. Using the search engines PubMed and Knight-Capron library the terms acute decompensated heart failure, heart failure, ultrasound, lung ultrasound, emergency department, and combined lung ultrasound for diagnosis of acute decompensated heart failure were searched. ­­­­­Eight relevant articles were identified from the search results and will serve as the basis for the clinical review. After reviewing the results from the relevant articles, it was determined that the overall sensitivity and specificity of LUS is superior for the diagnosis of ADHF in the ED in comparison to the most commonly used alternative diagnostic methods including chest x-ray (CXR), bedside echocardiography, BNP, NT-proBNP, and ECG. In patients presenting with signs and symptoms indicating the possible diagnosis of ADHF, evidence-based research supports the use of point-of-care (POC) LUS as it showed to improve diagnostic accuracy and aid in directing appropriate patient management.


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