From: Approach to undifferentiated dyspnea in emergency department: aids in rapid clinical decision-making
ADHF (systolic dysfunction) | Acute interstitial syndrome (the presence of multiple diffuse bilateral B-lines) with LV dysfunction on cardiac USG |
Acute pneumonia | Lung USG showing focal B-lines, subpleural echo poor region with tissue-like echotexture and dynamic air bronchogram with normal LV function. |
ARDS | Acute interstitial syndrome (presence of multiple diffuse bilateral B-lines) in non-homogenous distribution and anterior subpleural consolidation, reduced lung sliding normal LV function with suggestive clinical presentation (sudden onset and suggestive sepsis). |
COPD or Obstructive airway disease | Bilateral A-lines with decreased lung sliding on lung USG with normal LV function and normal kidneys with key indicators of COPD present clinically. |
Acute Pulmonary Embolism | Normal LV function, A-lines on lung USG with or without focal B-lines, dilated RV, dilated IVC with low collapsibility index with high pre-test probability of PE. |
Chronic lung disease (ILD or chronic lung fibrosis) | Normal LV function, irregular fragmented pleural line, subpleural abnormalities, bilateral B-lines in non- homogenous distribution with or without dilated RV and dilated IVC with low collapsibility index with suggestive clinical picture (h/o chronic exertional dyspnea and cough). |
Diastolic Heart Failure | Normal LV function with LV hypertrophy (LVH), left atrial enlargement, multiple diffuse bilateral B-lines, dilated IVC with low collapsibility index with suggestive clinical presentation (e.g., hypertensive, diabetic) |
Volume overload | Normal LV function, normal RV, multiple diffuse bilateral B-lines, dilated IVC, contracted kidneys. |
Pneumothorax | Normal LV function, bilateral A-lines with absent lung sliding with observed lung point with suggestive clinical picture. |
Tamponade | Normal LV function, pericardial effusion with dilated and non-collapsible IVC and RA/RV diastolic collapse with suggestive clinical signs. |