Lung Ultrasound for the Cardiologist

JACC Cardiovasc Imaging. 2018 Nov;11(11):1692-1705. doi: 10.1016/j.jcmg.2018.06.023.

Abstract

For a cardiologist, lung ultrasound is an add-on to transthoracic echocardiography, just as lung auscultation is part of a cardiac physical examination. A cardiac 3.5- to 5.0-MHz transducer is generally suitable because the small footprint makes it ideal for scanning intercostal spaces. The image quality is often adequate, and the lung acoustic window is always patent. The cumulative increase in imaging time is <1 min for the 2 main applications targeted on pleural water (pleural effusion) and lung water (pulmonary congestion as multiple B-lines). In these settings, lung ultrasound outperforms the diagnostic accuracy of the chest radiograph, with a low-cost, portable, real-time, radiation-free method. A "wet lung" detected by lung ultrasound predicts impending acute heart failure decompensation and may trigger lung decongestion therapy. The doctors of tomorrow may still listen with a stethoscope to their patient's lung, but they will certainly be seeing it with ultrasound.

Keywords: chest sonography; echocardiography; pleural effusion; pulmonary congestion; thoracic ultrasound.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Cardiologists*
  • Echocardiography
  • Heart Diseases / diagnostic imaging*
  • Heart Diseases / physiopathology
  • Heart Diseases / therapy
  • Humans
  • Lung / diagnostic imaging*
  • Lung / physiopathology
  • Lung Diseases / diagnostic imaging*
  • Lung Diseases / physiopathology
  • Lung Diseases / therapy
  • Predictive Value of Tests
  • Prognosis
  • Ultrasonography*