{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:44:47Z","timestamp":1791963887930,"version":"4.3.4"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>ST-elevation myocardial infarction (STEMI) remains a leading cause of morbidity and mortality globally. Early risk stratification and detection of complications are critical for optimizing patient outcomes. Point-of-care ultrasound (POCUS) has emerged as a valuable bedside tool in the acute evaluation of STEMI patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To explore the role of POCUS in the early assessment of STEMI patients, focusing on its diagnostic and prognostic utility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive review of current literature was conducted, examining the application of POCUS in STEMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lung ultrasound (LUS) enables rapid detection of pulmonary congestion through the identification of B-lines, offering superior sensitivity compared to traditional methods. Left ventricular outflow tract velocity-time integral (LVOT-VTI) provides a quantitative assessment of stroke volume and cardiac output, aiding in the identification of low-flow states. Integrating these modalities enhances hemodynamic evaluation. Moreover, a systematic POCUS assessment may facilitate early detection of high-risk patients with acute heart failure or cardiogenic shock, as well as the identification of mechanical complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incorporation of POCUS, specifically LUS and LVOT-VTI, into the early evaluation of STEMI patients enhances diagnostic accuracy and prognostic assessment. Future research should focus on standardizing protocols and evaluating the impact of POCUS-guided management on patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1627396","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T05:33:11Z","timestamp":1756791191000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Point-of-care ultrasound in the evaluation of STEMI patients"],"prefix":"10.3389","volume":"12","author":[{"given":"Marco Vugman","family":"Wainstein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Pinheiro","family":"Machado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Heiden","family":"Telo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anderson Donelli da","family":"Silveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Ant\u00f4nio","family":"Nasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo Neves de","family":"Araujo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e771","DOI":"10.1161\/CIR.0000000000001309","article-title":"2025 ACC\/AHA\/ACEP\/NAEMSP\/SCAI guideline for the management of patients with acute coronary syndromes: a report of the American college of cardiology\/American heart association joint committee on clinical practice guidelines","volume":"151","author":"Rao","year":"2025","journal-title":"Circulation"},{"key":"B2","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/0002-9149(67)90023-9","article-title":"Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients","volume":"20","author":"Killip","year":"1967","journal-title":"Am J Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1001\/jamacardio.2018.0001","article-title":"Time to add a fifth pillar to bedside physical examination inspection, palpation, percussion, auscultation, and insonation","volume":"3","author":"Narula","year":"2018","journal-title":"JAMA Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s13054-021-03466-z","article-title":"Bedside POCUS during ward emergencies is associated with improved diagnosis and outcome: an observational, prospective, controlled study","volume":"25","author":"Zieleskiewicz","year":"2021","journal-title":"Crit Care"},{"key":"B5","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1186\/s13054-016-1399-x","article-title":"Ultrasonography in the emergency department","volume":"20","author":"Whitson","year":"2016","journal-title":"Crit Care"},{"key":"B6","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1186\/s13054-023-04495-6","article-title":"Diagnostic accuracy of point-of-care ultrasound for shock: a systematic review and meta-analysis","volume":"27","author":"Yoshida","year":"2023","journal-title":"Crit Care"},{"key":"B7","first-page":"697","article-title":"Reliability and prognostic value of traditional signs and symptoms in outpatients with congestive heart failure","volume":"20","author":"Rohde","year":"2004","journal-title":"Can J Cardiol"},{"key":"B8","volume-title":"Does This Dyspneic Patient in the Emergency Department Have Congestive Heart Failure? The Rational Clinical Examination Section Editors","author":"Wang","year":"2005"},{"key":"B9","doi-asserted-by":"publisher","first-page":"46","DOI":"10.5811\/westjem.2015.11.28525","article-title":"Point-of-Care multi-organ ultrasound improves diagnostic accuracy in adults presenting to the emergency department with acute dyspnea","volume":"17","author":"Mantuani","year":"2016","journal-title":"West J Emerg Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1016\/j.annemergmed.2018.04.002","article-title":"Does point-of-care ultrasonography improve clinical outcomes in emergency department patients with undifferentiated hypotension? An international randomized controlled trial from the SHoC-ED investigators","volume":"72","author":"Atkinson","year":"2018","journal-title":"Ann Emerg Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.1056\/NEJMra1916062","article-title":"Point-of-care ultrasonography.","volume":"385","author":"D\u00edaz-G\u00f3mez","year":"2021","journal-title":"N Engl J Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1378\/chest.07-2800","article-title":"Relevance of lung ultrasound in the diagnosis of acute respiratory failure the BLUE protocol","volume":"134","author":"Lichtenstein","year":"2008","journal-title":"Chest"},{"key":"B13","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1097\/00005373-199304000-00008","article-title":"Prospective evaluation of surgeon`s use of ultrasound in the evaluation of trauma patients","volume":"34","author":"Rozycki","year":"1993","journal-title":"J Trauma"},{"key":"B14","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.emc.2009.09.010","article-title":"The RUSH exam: rapid ultrasound in SHock in the evaluation of the critically lll","volume":"28","author":"Perera","year":"2010","journal-title":"Emerg Med Clin North Am"},{"key":"B15","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/s13054-024-04861-y","article-title":"The elusive relationship between cardiac filling and fluid responsiveness","volume":"28","author":"Kenny","year":"2024","journal-title":"Crit Care"},{"key":"B16","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1097\/ALN.0b013e318229a500","article-title":"An increase in aortic blood flow after an infusion of 100 ml colloid over 1 minute can predict fluid responsiveness: the mini-fluid challenge study","volume":"115","author":"Muller","year":"2011","journal-title":"Anesthesiology"},{"key":"B17","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/j.echo.2013.04.001","article-title":"Focused cardiac ultrasound: recommendations from the American society of echocardiography","volume":"26","author":"Spencer","year":"2013","journal-title":"J Am Soc Echocardiogr"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.36660\/abchf.20240010i","article-title":"Contribution of lung ultrasound and VExUS in the diagnosis and monitoring of patients with heart failure","volume":"4","author":"Telo","year":"2024","journal-title":"ABC Heart Fail Cardiomyop"},{"key":"B19","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1093\/ehjacc\/zuad048","article-title":"Venous excess ultrasound score and acute kidney injury in patients with acute coronary syndrome","volume":"12","author":"Viana-Rojas","year":"2023","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e20250093","DOI":"10.36660\/abc.20250093","article-title":"Venous excess ultrasound (VExUS) score in patients with ST-elevation myocardial infarction to predict in-hospital mortality","volume":"122","author":"Machado","year":"2025","journal-title":"Arq Bras Cardiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1626497","DOI":"10.3389\/fcvm.2025.1626497","article-title":"Prognostic role of pre-procedural lung ultrasound in patients undergoing transcatheter aortic valve implantation","volume":"12","author":"Machado","year":"2025","journal-title":"Front Cardiovasc Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"2107","DOI":"10.1002\/ejhf.3365","article-title":"Pulmonary congestion assessed by lung ultrasound in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation: prevalence and prognostic implications","volume":"26","author":"Lillo","year":"2024","journal-title":"Eur J Heart Fail"},{"key":"B23","volume-title":"The Comet-tail Artifact An Ultrasound Sign of Alveolar-Interstitial Syndrome","author":"Lichtenstein","year":"1997"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1692","DOI":"10.1016\/j.jcmg.2018.06.023","article-title":"Lung ultrasound for the cardiologist","volume":"11","author":"Picano","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"B25","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1007\/s00134-012-2513-4","article-title":"International evidence-based recommendations for point-of-care lung ultrasound","volume":"38","author":"Volpicelli","year":"2012","journal-title":"Intensive Care Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1111\/acem.12435","article-title":"Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis","volume":"21","author":"Al Deeb","year":"2014","journal-title":"Acad Emerg Med"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1093\/ehjci\/jead169","article-title":"Lung ultrasound in acute and chronic heart failure: a clinical consensus statement of the European association of cardiovascular imaging (EACVI)","volume":"24","author":"Gargani","year":"2023","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.1002\/ejhf.1604","article-title":"Lung ultrasound-guided treatment in ambulatory patients with heart failure: a randomized controlled clinical trial (LUS-HF study)","volume":"21","author":"Rivas-Lasarte","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1709","DOI":"10.1016\/j.amjcard.2010.08.024","article-title":"Comparison of prognostic value of echocardiacgraphic risk score with the thrombolysis in myocardial infarction (TIMI) and global registry in acute coronary events (GRACE) risk scores in acute coronary syndrome","volume":"106","author":"Bedetti","year":"2010","journal-title":"Am J Cardiol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e010269","DOI":"10.1161\/CIRCIMAGING.119.010269","article-title":"Admission bedside lung ultrasound reclassifies mortality prediction in patients with ST-segment-elevation myocardial infarction","volume":"13","author":"Araujo","year":"2020","journal-title":"Circ Cardiovasc Imaging"},{"key":"B31","first-page":"e20250022","article-title":"Assessment of interrater reliability in point-of-care ultrasound for assessing congestion in cardiovascular intensive care","volume":"38","author":"Saadi","year":"2025","journal-title":"Arq Bras Cardiol: Imagem cardiovasc"},{"key":"B32","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1002\/ajum.12347","article-title":"Lung ultrasound: a comparison of image interpretation accuracy between curvilinear and phased array transducers","volume":"26","author":"Walsh","year":"2023","journal-title":"Australas J Ultrasound Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.echo.2018.06.004","article-title":"Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: recommendations from the American society of echocardiography","volume":"32","author":"Mitchell","year":"2019","journal-title":"J Am Soc Echocardiogr"},{"key":"B34","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1093\/ehjacc\/zuac084","article-title":"Doppler-derived haemodynamics performed during admission echocardiography predict in-hospital mortality in cardiac intensive care unit patients","volume":"11","author":"Jentzer","year":"2022","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"B35","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s13089-020-00170-x","article-title":"Rationale for using the velocity\u2013time integral and the minute distance for assessing the stroke volume and cardiac output in point-of-care settings","volume":"12","author":"Blanco","year":"2020","journal-title":"Ultrasound J"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2031","DOI":"10.1161\/01.CIR.102.17.2031","article-title":"TIMI Risk score for ST-elevation myocardial infarction: a convenient, bedside, clinical score for risk assessment at presentation","volume":"102","author":"Morrow","year":"2000","journal-title":"Circulation"},{"key":"B37","doi-asserted-by":"publisher","first-page":"2345","DOI":"10.1001\/archinte.163.19.2345","article-title":"Predictors of hospital mortality in the global registry of acute coronary events.","volume":"163","author":"Granger","year":"2003","journal-title":"Arch Intern Med"},{"key":"B38","doi-asserted-by":"publisher","first-page":"107","DOI":"10.5935\/abc.20140091","article-title":"Validation of the killip\u2013kimball classification and late mortality after acute myocardial infarction","volume":"103","author":"de Mello","year":"2014","journal-title":"Arq Bras Cardiol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1093\/ehjacc\/zuae073","article-title":"Killip scale reclassification according to lung ultrasound: killip pLUS","volume":"13","author":"Carreras-Mora","year":"2024","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"B40","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1093\/ehjacc\/zuae086","article-title":"In response to \u2018killip scale reclassification according to lung ultrasound: killip pLUS\u2019, by carreras-Mora et al","volume":"13","author":"de Araujo","year":"2024","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.1136\/heartjnl-2023-322690","article-title":"Subclinical congestion assessed by lung ultrasound in ST segment elevation myocardial infarction","volume":"109","author":"Carreras-Mora","year":"2023","journal-title":"Heart"},{"key":"B42","doi-asserted-by":"publisher","first-page":"e035688","DOI":"10.1161\/JAHA.124.035688","article-title":"Lung ultrasound in the acute phase of ST-segment-elevation acute myocardial infarction: 1-year prognosis and improvement in risk prediction","volume":"13","author":"Carreras-Mora","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"B43","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1016\/j.jacc.2022.01.018","article-title":"SCAI SHOCK stage classification expert consensus update: a review and incorporation of validation studies: this statement was endorsed by the American college of cardiology (ACC), American college of emergency physicians (ACEP), American heart association","volume":"79","author":"Naidu","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.jcmg.2022.09.005","article-title":"Lung ultrasound evaluation of SCAI shock stages predicts mortality in ST-segment elevation myocardial infarction","volume":"16","author":"Scolari","year":"2022","journal-title":"JACC Cardiovasc Imaging"},{"key":"B45","doi-asserted-by":"publisher","first-page":"e011641","DOI":"10.1161\/CIRCIMAGING.120.011641","article-title":"Comparison of admission lung ultrasound and left ventricular End-diastolic pressure in patients undergoing primary percutaneous coronary intervention","volume":"14","author":"Araujo","year":"2021","journal-title":"Circ Cardiovasc Imaging"},{"key":"B46","doi-asserted-by":"publisher","first-page":"2167","DOI":"10.1007\/s11739-024-03719-z","article-title":"A combination of left ventricular outflow tract velocity time integral and lung ultrasound to predict mortality in ST elevation myocardial infarction","volume":"19","author":"Machado","year":"2024","journal-title":"Intern Emerg Med"},{"key":"B47","doi-asserted-by":"crossref","DOI":"10.1016\/S0002-9149(77)80182-3","volume-title":"Correlative Classification of Clinical and Hemodynamic Function After Acute Myocardial Infarction","author":"Forrester","year":""},{"key":"B48","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1007\/s11739-025-03920-8","article-title":"Comparing ultrasound-based prognostic classifications in STEMI: is LUV better than LUCK?","volume":"20","author":"Machado","year":"2025","journal-title":"Intern Emerg Med"},{"key":"B49","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1002\/ccd.27427","article-title":"Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: the detroit cardiogenic shock initiative","volume":"91","author":"Basir","year":"2018","journal-title":"Catheter Cardiovasc Interv"},{"key":"B50","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1093\/ehjci\/jeae149","article-title":"Systematic hand-held echocardiography in patients hospitalized with acute coronary syndrome","volume":"25","author":"Geers","year":"2024","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"B51","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1002\/clc.22754","article-title":"Handheld echocardiography during hospitalization for acute myocardial infarction","volume":"40","author":"Cullen","year":"2017","journal-title":"Clin Cardiol"},{"key":"B52","doi-asserted-by":"publisher","first-page":"ehae666-1723","DOI":"10.1093\/eurheartj\/ehae666.1723","article-title":"Impact of a cardiothoracic ultrasound protocol in patients with ST-elevation myocardial infarction: the Focused Assessment in STEMI (FASTEMI) protocol","volume":"45","author":"Amon","year":"2024","journal-title":"Eur Heart J"},{"key":"B53","doi-asserted-by":"publisher","first-page":"4933","DOI":"10.1002\/ehf2.13527","article-title":"Diamond\u2013forrester classification using echocardiography haemodynamic assessment in cardiac intensive care unit patients","volume":"8","author":"Kim","year":"2021","journal-title":"ESC Heart Fail"},{"key":"B54","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.ihj.2020.11.148","article-title":"Lung ultrasound in acute myocardial infarction. Updating killip & kimball","volume":"73","author":"Parras","year":"2021","journal-title":"Indian Heart J"},{"key":"B55","doi-asserted-by":"publisher","first-page":"881626","DOI":"10.3389\/fphys.2022.881626","article-title":"Pulmonary congestion assessed by lung ultrasound and cardiovascular outcomes in patients with ST-elevation myocardial infarction","volume":"13","author":"Araiza-Garaygordobil","year":"2022","journal-title":"Front Physiol"}],"updated-by":[{"DOI":"10.3389\/fcvm.2025.1698664","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000}}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1627396\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T05:26:59Z","timestamp":1759123619000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1627396\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,2]]},"references-count":55,"alternative-id":["10.3389\/fcvm.2025.1627396"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1627396","relation":{"correction":[{"id-type":"doi","id":"10.3389\/fcvm.2025.1698664","asserted-by":"object"}]},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,2]]},"article-number":"1627396"}}