SHM Converge Scientific Abstract ePoster Gallery-"False Ventricle Sign": How Point of Care Ultrasound Could Have Expedited an Uncommon Diagnosis Through a Common Exam

"False Ventricle Sign": How Point of Care Ultrasound Could Have Expedited an Uncommon Diagnosis Through a Common Exam

Pdf Summary

This case report describes how point-of-care ultrasound (POCUS), commonly used to evaluate undifferentiated dyspnea, may have identified an unusual malignancy earlier in an incarcerated 46-year-old man with four months of right shoulder pain, worsening shortness of breath, and a syncopal episode. On POCUS, he had a large mediastinal mass that mimicked a poorly functioning right ventricle, along with a distended inferior vena cava and pleural effusion. The mass created a misleading image the authors call the “False Ventricle Sign.”<br /><br />Further workup showed the mass was synovial sarcoma. Because it measured 15 cm and was compressing major vessels, including the superior vena cava, it was deemed unresectable. The patient was treated with palliative radiation and chemotherapy.<br /><br />The authors emphasize that although POCUS is recommended by American College of Physicians guidelines for evaluating acute dyspnea in emergency and inpatient settings, its use in outpatient settings could also help detect serious disease earlier, especially in underserved or vulnerable populations. They also stress the need for improved POCUS training so clinicians can better interpret findings and avoid diagnostic pitfalls.

Asset Subtitle

Julia Frey

Meta Tag

Author List Aaron Silver, Julia Frey

Category Clinical Vignettes

Concept Point-of-Care Ultrasound

Concept Dyspnea

Concept POCUS Interpretation

Concept Mediastinal Mass

Concept False Ventricle Sign

Distinguished Non-Finalist

Presenter Organization Oregon Health & Science University

Presenting Author Julia Frey

Track Adult

Keywords

point-of-care ultrasound

POCUS

mediastinal mass

false ventricle sign

synovial sarcoma

dyspnea

inferior vena cava distension

pleural effusion

superior vena cava compression

palliative radiation

Point-of-Care Ultrasound

Dyspnea

POCUS Interpretation

Mediastinal Mass

False Ventricle Sign