Diagnostic accuracy of lung ultrasound in acute heart failure

Abstract

Background and objective Although acute heart failure (AHF) is a common cause of dyspnea, its diagnosis still represents a challenge. Lung ultrasound is an emerging point-of-care diagnostic tool, but its diagnostic performance for AHF is still under evaluation. We evaluated the accuracy and clinical usefulness of combining lung ultrasound with clinical assessment compared with the use of chest radiography, echocardiography, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in conjunction with clinical evaluation for diagnosing AHF in the emergency department. Patients and methods A total of 47 patients presenting with dyspnea and symptoms suggestive of AHF were evaluated by NT-proBNP, echocardiography, and chest radiography. Lung ultrasound was done to look for the presence of diffuse B-lines. Results Lung ultrasound showed a sensitivity of 91.9% and a specificity of 100% in diagnosing AHF comparable to plasma NT-proBNP, which had a sensitivity of 100% and a specificity of 60%. It was also superior to other methods of diagnosing AHF namely chest radiograph. Lung ultrasound showed a significant correlation with the echocardiography findings (P=0.001). Conclusion The implementation of lung ultrasound with the clinical evaluation improves accuracy of diagnosis of AHF in the emergency department.