Point-of-care Ultrasound Identification of Tension Hydrothorax in the Emergency Department: A Case Series

Tension hydrothorax is an uncommon emergent condition in which hemodynamic instability and respiratory compromise may occur. Emergency physicians may diagnose tension hydrothorax by point-of-care ultrasound.

We discuss the key sonographic features assisting in identification. Four patients with history of malignancy who were found to have tension hydrothorax exhibited the following common ultrasound findings: massive, left-sided pleural effusion; complete, compressive atelectasis; and shift of cardiac structures into the right hemithorax, resulting in right-sided probe placement to obtain cardiac views.

This is the first instance to our knowledge of point-of-care ultrasound findings in tension hydrothorax to be described in the literature.