POCUS Note

Emergency Medicine Registrar **POCUS note :** "Explained this is point of care ultrasound and not for ultrasound, which might be required if felt clinically appropriate." "Images stored on" Mindray M7 Ultrasound System **Clinical Indication:** Acute shortness of breath, suspicion of cardiac dysfunction or pulmonary oedema. **Echocardiography:** LV - Moderately reduced global systolic function, estimated ejection fraction 40-45%. RV - Mildly dilated with normal systolic function, RV/LV ratio approximately 0.7. MV - Normal morphology, good mobility. Trace mitral regurgitation. TV - Normal morphology, good mobility. Mild tricuspid regurgitation. AV - Normal trileaflet morphology, good excursion. No regurgitation or stenosis. Pericardium - No pericardial effusion identified. IVC - Dilated (2.5 cm) with <50% respiratory collapsibility, suggesting elevated right atrial pressure. Haemodynamics - LVOT VTI 18 cm, calculated stroke volume 55 mL. **Lung Ultrasound:** Bilateral diffuse B-lines (lung rockets) in multiple zones, consistent with interstitial oedema. Good lung sliding bilaterally. No pleural effusions or consolidation identified. **Clinical Impression:** Findings are consistent with acute decompensated heart failure with signs of elevated filling pressures and pulmonary oedema. Moderately reduced left ventricular systolic function noted. **Recommendations:** Initiate diuresis. Further cardiology review for formal echocardiogram and management plan for heart failure. Monitor oxygen saturation and respiratory effort closely. Dr. Alex Chen Emergency Medicine Registrar MBBS, FRANZEM (Provisional)