Abstract
Dyspnea is a non-specific symptom that requires fast diagnostics, accurate diagnosis and proper treatment. The most common causes of dyspnea include exacerbation of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Distinction between these two medical conditions seems to be critical in diagnostics of emergencies. At the same time, basic diagnostic tools available in emergency room, such as classic radiography (X-ray) of the chest, electrocardiography (ECG) or b-type natriuretic peptide test, are sometimes ambiguous. Therefore looking for additional diagnostic tool seems to be justified and necessary. Transthoracic lung ultrasound assessment is a simple and easily accessible examination, enabling the early and explicit diagnostics of pulmonary oedema and its distinction from other, non-cardiac causes of dyspnea. This review outlines the current knowledge on the subject of transthoracic lung ultrasound (TLUS), particularly in respect of its clinical usefulness in distinction of causes of dyspnea exacerbation.
Highlights
Exacerbation of chronic dyspnea is a non -specific symptom that require fast diagnostics, accurate diagnosis and proper treatment
The most common causes of chronic dyspnea exacerbation include the exacerbation of chronic obstructive pulmonary disease (COPD) or the exacerbation of chronic heart failure (CHF)
Frequency of hospitalization and mortality connected with exacerbation of COPD and cardiovascular diseases is considerable, and distinction between exactly these two causes of dyspnea seems to be critical in diagnostics of emergencies, and in conditions of the rescue unit it still is a challenge, in the group of elderly patients, with other comorbidities
Summary
Exacerbation of chronic dyspnea is a non -specific symptom that require fast diagnostics, accurate diagnosis and proper treatment. Normal image of the chest X-ray cannot certainly rule out cardiogenic pulmonary oedema as the cause of dyspnea. The more so, because a normal chest X-ray is observed even in clinical situations of an increase in PCWP up to more than 30 mm Hg, in the above-mentioned group of patients with exacerbation of CHF, previously “adopted” to changes in the pulmonary circulation.
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