Accuracy of point of care ultrasound in evaluation of patients with dyspnea and chest pain in the emergency department

Aim: Dyspnea and chest pain are common principal complaints among individuals who present to the Emergency Department (ED). Point of care ultrasound (POCUS) is more accurate than chest X-Ray (CXR) for the diagnosis of diseases most typically found in patients with chest discomfort and dyspnea. In this study, we aimed to assess the diagnostic accuracy of POCUS in cases presented to the emergency rooms with dyspnea and/or chest discomfort. Material and Methods: Patients with dyspnea and/or chest pain were submitted to POCUS protocol, which includes lung ultrasound, echocardiography, inferior vena cava (IVC) and deep vein thrombosis (DVT) scans between December 2020 and December 2021. Pre- POCUS diagnoses and POCUS diagnoses were compared to final diagnosis to detect the degree of agreement. Results: One hundred patients were enrolled in this study. POCUS was 100 % accurate in diagnosing cases of pneumothorax; 99 % accurate in diagnosing pleural effusion; 98 % accurate in diagnosing pulmonary edema; and 95 % accurate in diagnosing pneumonia. It has excellent agreement with cases of acute coronary syndrome (ACS), pulmonary embolism (PE), and pneumothorax (kappa index = 1), as well as a nearly perfect agreement with pulmonary edema (kappa index = 0.842). Discussion: POCUS is a practical and reliable diagnostic tool that can help in narrowing down the differential diagnoses and shortening the diagnostic time in the assessment of patients with dyspnea and/ or chest pain in the ED.