Lung Ultrasound for the Cardiologist
Author + information
- Eugenio Picano, MD, PhDa,∗ (picano{at}ifc.cnr.it),
- Maria Chiara Scali, MD, PhDb,
- Quirino Ciampi, MD, PhDc and
- Daniel Lichtenstein, MDd
- aCNR Institute of Clinical Physiology, Pisa, Italy
- bCardiology Department, Nottola Hospital, Siena, Italy
- cCardiology Division, Fatebenefratelli Hospital, Benevento, Italy
- dMedical Intensive Care Unit, Ambroise-Paré Hospital, Paris-West University, Boulogne, France
- ↵∗Address for correspondence:
Dr. Eugenio Picano, Institute of Clinical Physiology, Italian National Research Council, Via Moruzzi 1, 56124 Pisa, Italy.
Central Illustration
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.
Footnotes
All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received January 25, 2018.
- Revision received May 25, 2018.
- Accepted June 19, 2018.
- 2018 American College of Cardiology Foundation
