Value of thoracic ultrasound including focused cardiac ultrasound in daily practice of outpatient chest clinic.

Background: Chest examination alone may be insufficient to declare cardiorespiratory diseases specially in its early stages and/or silent forms, also it is impractical for the CXR and cardiac consultation to be requested for every patient in the outpatient clinic, therefore involving the chest US and FoCUS (Focused Cardiac Ultra Sound) examination in the bedside practice of outpatient chest clinic may influence the clinical diagnosis and management plan.

Objective: To determine how the bedside thoracic US including FoCUS can alter the clinical diagnosis in patients who are clinically diagnosed as acute bronchitis in the outpatient chest clinic.

Subjects and methods: This study was conducted at Chest outpatient clinic, Al-Azhar University in the period between January 2024 to March 2025. 300 patients diagnosed clinically as acute bronchitis were evaluated by bedside chest ultrasound and FoCUS.

Results: A prospective cross sectional study including 300 patients clinically diagnosed as acute bronchitis and evaluated by the bedside chest US including FoCUS which was additive and/or changing in clinical diagnosis in 31 (10.3%) of the studied patients, the sonographic evidence of pneumonia was present in 17 (5.7%) patients, the interstitial lung disease ILD was suggested in 5 (1.7%) patients, the clinic-sonographic diagnosis of heart failure was present in 7 (2.3%), the findings of mitral stenosis was present in 2 (0.7%).

Conclusion: The practice of bedside chest US including FoCUS should not be restricted to the emergency rooms and ICUs but also should be extended to the outpatient clinic as it can diagnose unexpected clinical problems, guide to the next investigational step, and shorten the time to the clinical diagnosis and recovery.