Jugular vein ultrasound and pulmonary oedema in patients with suspected congestive heart failure.
BACKGROUND
The diagnosis of patients with acute dyspnoea is challenging, as clinical history and physical examination are often nondiagnostic and inaccurate. Consequently, clinicians often rely on the results of chest radiography (CXR) to determine the initial intervention and guide further treatment.


OBJECTIVE
The purpose of this study was to prospectively assess the sensitivity and specificity of ultrasonographic assessment of jugular venous distension (US-JVD) for identifying pulmonary oedema on CXR in dyspnoeic patients with suspected congestive heart failure.


METHODS
US-JVD was compared with initial CXR findings of pulmonary oedema as determined by radiology consultants blinded to all clinical information and US-JVD measurements.


RESULTS
US-JVD had a sensitivity of 98.2% [95% confidence interval (CI), 89.2-99.9] and a specificity of 42.9% (95% CI, 30.7-55.9), a likelihood ratio positive of 1.7 (95% CI, 1.4-2.1), and likelihood ratio negative of 0.04 (95% CI, 0.006-0.3), for identifying dyspnoeic patients with pulmonary oedema on initial CXR.


CONCLUSIONS
US-JVD is a sensitive test for identifying pulmonary oedema on CXR in dyspnoeic patients with suspected congestive heart failure.
aDavid Geffen School of Medicine at UCLA bDivision of Emergency Medicine, Washington University School of Medicine, St Louis, Missouri cHarbor-UCLA Medical Center, Department of Emergency Medicine dLA Biomed Research Institute, Carson St Torrance, California, USA.
Timothy
T
Jang
Chandra
C
Aubin
Rosanne
R
Naunheim
Lawrence M
LM
Lewis
Amy H
AH
Kaji
D000368:Aged; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D004417:Dyspnea / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013902:Radiography, Thoracic / Q000379:methods; D012680:Sensitivity and Specificity; D014463:Ultrasonography