The Cutting Edge Veterinary Podcast

STUDENT(S): Rebecca Vavrek, Spencer Smith, Sukhjit Sidhu
FACULTY MENTOR(S): Dr’s. Soren Boysen and Julie Menard
ABSTRACT
Left-sided congestive heart failure (L-CHF) is a common emergency presentation in small animal practice, manifesting as respiratory distress secondary to cardiogenic pulmonary edema. Such emergencies require rapid intervention. Point-of-care ultrasound (POCUS) is a patient side diagnostic that is swiftly integrated into triage. A powerful application of POCUS is rapid diagnosis of pulmonary edema secondary to L-CHF in unstable patients, allowing non-specialists to make treatment decisions based on sonographic signs of L-CHF. This paper focuses on identification of L-CHF using POCUS, but also includes methods of patient stabilization using oxygen and anxiolytics. We highlight the use of POCUS to diagnose L-CHF by outlining POCUS landmarks and corresponding pleural and lung space ultrasonography (PLUS) and cardiac findings. Additionally, other possible differentials are provided. Ultimately, identification of L-CHF can be made on patients presenting with respiratory distress through POCUS to identify diffuse B-lines on PLUS and an enlarged left atrium to aorta ratio ≥ 2:1. Such findings indicate beginning L-CHF treatment. Finally, we conclude with a literature-based comparison of POCUS to conventional methods of diagnosis of L-CHF and a diagnosis algorithm. Ideally, this paper improves the confidence of clinicians to rapidly diagnose and begin treatment of L-CHF using POCUS.

Release date:

29 September 2024