# The rise of point-of-care ultrasound in cardiopulmonary diagnostics

## TL;DR

Point-of-care ultrasound is becoming a vital tool in acute cardiovascular care by offering real-time, non-invasive diagnostics and guiding treatment decisions.

## Contribution

The paper highlights how POCUS integrates multiple ultrasound techniques to improve diagnosis and management of cardiopulmonary conditions.

## Key findings

- Lung ultrasound outperforms chest X-ray in detecting pulmonary congestion.
- Venous Excess Ultrasound Score provides a structured assessment of venous congestion.
- LVOT-VTI and focused cardiac ultrasound enable rapid evaluation of cardiac function.

## Abstract

Point-of-care ultrasound (POCUS) has rapidly evolved from a diagnostic adjunct into an essential extension of bedside clinical reasoning in acute cardiovascular care. By providing immediate, physiologically grounded, and non-invasive information, POCUS enhances diagnostic accuracy, risk stratification, and therapeutic guidance in real time. Among its core applications, lung ultrasound enables reliable detection and monitoring of pulmonary congestion, outperforming traditional methods such as chest X-ray and physical examination. The Venous Excess Ultrasound Score offers a structured assessment of systemic venous congestion through abdominal venous Doppler patterns. The left ventricular outflow tract velocity–time integral serves as a reproducible surrogate of forward flow and cardiac output, while focused cardiac ultrasound provides rapid structural and functional evaluation of the heart. The reliability and prognostic value of these modalities have been supported by growing evidence across diverse clinical contexts, though standardization of training and acquisition protocols remains crucial for widespread implementation. Integration of POCUS into daily workflows—through structured, serial assessments of pulmonary, venous, and haemodynamic status—holds promise to refine decision-making, individualize treatment strategies, and improve outcomes. This review summarizes current evidence, methodological considerations, and practical implications of POCUS in acute cardiovascular medicine, emphasizing its complementarity to, rather than replacement of, traditional diagnostic tools.

Graphical AbstractPoint-of-care ultrasound (POCUS) provides condition-specific multimodal assessment in acute cardiovascular care. In acute decompensated heart failure, it integrates lung ultrasound (LUS) and Venous Excess Ultrasound Score (VExUS) for congestion profiling, complemented by left ventricular outflow tract velocity–time integral (LVOT-VTI) for flow evaluation and focused cardiac ultrasound (FoCUS) for structural assessment. In ST-elevation myocardial infarction, LUS and LVOT-VTI assess pulmonary congestion and forward flow, FoCUS identifies ventricular dysfunction and mechanical complications, and VExUS evaluates systemic venous repercussion. In cardiogenic shock, echodynamic profiling with LVOT-VTI and related parameters supports serial haemodynamic monitoring, while LUS aids risk stratification and FoCUS enables structural and functional evaluation.

Point-of-care ultrasound (POCUS) provides condition-specific multimodal assessment in acute cardiovascular care. In acute decompensated heart failure, it integrates lung ultrasound (LUS) and Venous Excess Ultrasound Score (VExUS) for congestion profiling, complemented by left ventricular outflow tract velocity–time integral (LVOT-VTI) for flow evaluation and focused cardiac ultrasound (FoCUS) for structural assessment. In ST-elevation myocardial infarction, LUS and LVOT-VTI assess pulmonary congestion and forward flow, FoCUS identifies ventricular dysfunction and mechanical complications, and VExUS evaluates systemic venous repercussion. In cardiogenic shock, echodynamic profiling with LVOT-VTI and related parameters supports serial haemodynamic monitoring, while LUS aids risk stratification and FoCUS enables structural and functional evaluation.