5. Major Lung Ultrasound Pathology Profiles

Cardiogenic Pulmonary Edema (CPE)

Ultrasound is useful for assessing the severity of cardiogenic pulmonary edema. Cardiogenic pulmonary edema is a type of pulmonary edema caused by increased pressures of the left side of the heart. This condition often occurs secondary to congestive heart failure when the left ventricle cannot pump out all the blood it receives from the lungs. The backed-up blood increases capillary hydrostatic pressure that then causes fluid to leak into both lungs, resulting in bilateral and symmetric B-lines.

As CPE progresses, more B-lines appear until they converge into vertical sheets, known as confluent B-lines. As fluid builds up further, expect to see bilateral transudative pleural effusions with atelectasis of the lungs. Cardiogenic pulmonary edema usually affects both lungs but can atypically affect a unilateral lung.

If you suspect your patient has CPE, it is also recommended to perform an ultrasound evaluation of their heart to assess for systolic and diastolic dysfunction of the left ventricle.

Cardiogenic Pulmonary Edema – Lung Ultrasound Profile:

  • Bilateral and Symmetric B-lines (can sometimes be unilateral)
  • Confluent B-lines with increasing severity
  • Pleural edema and/or bilateral effusions with increasing severity
  • Lung Sliding Present
Severely Decreased Ejection Fraction
Confluent B-Lines Lung Ultrasound
Confluent B-Lines

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