Lung ultrasound for diagnosis of acute heart failure (April 2019)
The diagnosis of acute decompensated heart failure (ADHF) can be challenging, as patients may present with nonspecific signs and symptoms. Lung ultrasound (LUS) enables detection of pulmonary edema; its potential role in the diagnosis of ADHF was assessed in the following studies:
●A meta-analysis including six studies with a total of over 1800 patients presenting with dyspnea found that LUS, compared with chest radiograph, had greater sensitivity (pooled estimates 0.88 and 0.73) and similar specificity (pooled estimate 0.90 for both) for detection of ADHF.
●A randomized trial that enrolled over 500 patients presenting to an emergency department with acute dyspnea found that LUS, but not a combination of chest radiograph plus natriuretic peptide testing, improved the diagnostic accuracy of initial clinical assessment for ADHF.
These findings suggest that LUS may be a helpful adjunct in the evaluation of patients presenting with dyspnea and possible ADHF, but LUS should not replace standard clinical assessment.
