Focused Ultrasound in the Emergency Department for the Diagnosis of Acute Heart Failure
The Emergency Department plays a key role in the initial diagnosis and management of acute heart failure (AHF). Despite the advent of novel biomarkers and traditional methods of assessment, diagnosis of short of breath ED patients remains challenging. Focused cardiac and pulmonary ultrasound has emerged as a valid, facile and efficient method to aid in the diagnosis and management of AHF. It may also help to identify alternative etiologies of acute dyspnea.
Frances M Russell
Key Learning Objectives
This webinar is to inform and educate interventional cardiologists and cardiac surgeons on:
- The diagnosis of acute heart failure (HF) may be challenging, especially in patients with co-morbid conditions, such as COPD
- Focused cardiac and lung ultrasound (US) may rapidly diagnosis and guide management in patients presenting with acute dyspnea. Specifically, lung US to assess for B-lines, as well as IVC (inferior vena cava) measurement and ejection fraction
- B-lines or comet tails are easily identified signs of extra-vascular lung water, which in the correct clinical setting is highly suggestive of pulmonary congestion
- Emergency Physicians
- Internal Medicine Physicians
Frances M Russell
Frances Russell, MD, RDMS, FACEP
Assistant Professor of Emergency Medicine
Division Chief, Emergency Ultrasound
Director, Emergency Ultrasound Fellowship
Department of Emergency Medicine
Indiana University School of Medicine
Indianapolis, IN 46202
1. Labovitz AJ, Noble VE, Bierig M, et al. Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians. J Am Soc Echocardiogr. 2010;23(12):1225-1230.
2. Gargani L, Frassi F, Soldati G, Tesorio P, Gheorghiade M, Picano E. Ultrasound lung comets for the differential diagnosis of acute cardiogenic dyspnoea: a comparison with natriuretic peptides. Eur J Heart Fail. 2008;10(1):70-77.
3. Russell FM, Ehrman RR, Cosby K, et al. Diagnosing acute heart failure in patients with undifferentiated dyspnea: a lung and cardiac ultrasound (LuCUS) protocol. Acad Emerg Med. 2015;22(2):182-191.
4. Chiem AT, Chan CH, Ander DS, Kobylivker AN, Manson WC. Comparison of Expert and Novice Sonographers' Performance in Focused Lung Ultrasonography in Dyspnea (FLUID) to Diagnose Patients With Acute Heart Failure Syndrome. Acad Emerg Med. 2015.
5. Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38(4):577-591.
6. Lichtenstein DA, Meziere GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest. 2008;134(1):117-125.
7. Volpicelli G, Caramello V, Cardinale L, Mussa A, Bar F, Frascisco MF. Bedside ultrasound of the lung for the monitoring of acute decompensated heart failure. Am J Emerg Med. 2008;26(5):585-591.
8. Blehar DJ, Dickman E, Gaspari R. Identification of congestive heart failure via respiratory variation of inferior vena cava diameter. Am J Emerg Med. 2009;27(1):71-75.