Lung Ultrasound Outperforms Chest X-Ray for Diagnosing Congestive Heart Failure

Bilateral presence of two or more lung zones with at least three B-lines had negative and positive predictive values of 92%.

Lung ultrasound can be used to diagnose congestive heart failure (CHF) via detection of B-lines — vertical hyperechoic lines extending from the pleural line to the bottom of the ultrasound screen that result from reverberation artifact owing to interstitial fluid in otherwise aerated lungs. In a multicenter Italian study, investigators assessed the accuracy of lung ultrasound for detecting CHF in patients presenting with acute dyspnea. Ultrasound was performed in the emergency department by trained emergency physicians. Adjudication by two experts who relied on all available data (but were blinded to lung ultrasound results) was the gold standard.

Among 1005 patients, the final diagnosis was acute decompensated heart failure in 46%. The nega…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Lung Ultrasound Outperforms Chest X-Ray for Diagnosing Congestive Heart Failure

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Reviewing Author