Clinical value of transthoracic ultrasonography in identifying causes of acute dyspnea: a cross-sectional analysis

Background and aim Dyspnea encompasses a wide range of subjective respiratory sensations. Its inherently subjective nature presents a significant challenge for clinicians. The purpose of this study is to describe the varoius sonographic patterns observed in this population and assess the diagnostic efficacy of transthoracic ultrasonography in patients who arrive at the emergency room with acute dyspnea. Patients and methods One hundred fifty patients were included in the study. Their age is more than 18 years and they suffer from acute dyspnea. Any patient with subcutaneous emphysema or morbid obesity was excluded. All patients were subjected to the following: a full medical history and the dyspnea graded by the NYHA classification, complete laboratory investigations, imaging includes transthoracic ultrasound, and high-resolution computed tomography or computed tomography angiography. Results The study identified distinct lung ultrasound profiles corresponding to various diseases. The A-profile was predominantly observed in patients with chronic obstructive pulmonary disease and asthma, while the A’-profile was most frequently associated with pneumothorax. Patients with consolidation, lung mass, and pulmonary embolism with infarction typically exhibited the C-profile. The B-profile was characteristic of interstitial pulmonary fibrosis, pulmonary edema, and in selected cases, pneumonia. The diagnostic performance of lung ultrasound for specific conditions demonstrated notable accuracy with high sensitivity and specificity. Conclusion Lung ultrasound and its various profiles are a valuable imaging modality for evaluating and providing a practical framework for the diagnosis of common cardiac and respiratory pathologies that present with acute dyspnea. These findings support the integration of lung ultrasound as a first-line diagnostic tool in emergency settings for patients with acute dyspnea.