Cardiac Ultrasound in Cardiovascular Emergency and Critical Care. A Clinical Consensus Statement of the European Association of Cardiovascular Imaging (EACVI), the Acute CardioVascular Care Association (ACVC) of the ESC, and the European Association of Cardiothoracic Anaesthesia and Intensive Care (EACTAIC)

Abstract

Cardiac ultrasound (CUS) has emerged as an indispensable bedside diagnostic and monitoring tool in cardiovascular emergencies and critical care, enabling rapid, noninvasive assessment of cardiac structure and function. This multidisciplinary consensus statement, jointly developed by the EACVI, ACVC, and EACTAIC, provides comprehensive, practical guidance on the use of CUS in acute care settings. The document outlines a pathophysiological framework for applying CUS across a wide spectrum of clinical scenarios, including cardiogenic shock, acute myocardial infarction, mechanical complications, acute heart failure, severe valvular disease, pericardial tamponade, pulmonary embolism, and cardiac arrest. It describes key ultrasound modalities, measurement techniques, and diagnostic considerations essential for accurate interpretation and decision-making. Emphasis is placed on integrating CUS with multimodal imaging and organ-specific ultrasound to improve diagnostic accuracy and risk stratification. The consensus further defines recommended training pathways, competence levels, and governance standards to ensure high-quality practice and mitigate medicolegal risks. Looking ahead, the document highlights future perspectives, including the transformative potential of artificial intelligence, big data, and connected technologies to enhance CUS capabilities. By standardising approaches and promoting interdisciplinary collaboration, this statement aims to optimise patient outcomes and advance the role of cardiac ultrasound as a cornerstone of emergency and critical cardiovascular care.