Heart Point in Pneumothorax: A Case Report and Comparison to Mimicking Signs

Lung ultrasound is increasingly used in critical care medicine to identify pneumothorax, usually by the absence of lung sliding and identification of the lung point. Heart point is a less recognized but specific sign in cardiac ultrasound indicating pneumothorax.

A 20-year-old Caucasian male presented with a pneumothorax after a traumatic resuscitation to the emergency room upon bilateral chest decompression being initiated. Upon presentation to the intensive care unit, there were no clinical signs of pulmonary compromise on mechanical ventilation. Performance of transthoracic echography at the ICU identified heart point, and the subsequent diagnosis of pneumothorax was made. A thoracic drain was inserted and resulted in the re-expansion of the lung. The chest tube was removed after 2 days.

The utility of point-of-care ultrasound in the diagnosis of pneumothorax is aided by awareness of heart point. Recognition is imperative to ensure prompt therapeutic measures and ensure improved patient outcomes. Knowledge of mimicking appearances such as pseudo heart point and air gap sign is essential to assure diagnostic accuracy.