Lung Consolidation as an Acoustic Window for Pulmonary Artery Visualization on Point‐of‐Care Ultrasound

ABSTRACT

Visualization of mediastinal vascular structures using transthoracic ultrasound is often limited by the presence of aerated lung, which reflects ultrasound waves and prevents imaging of deeper structures. In contrast, lung consolidation can replace air with fluid‐filled tissue, allowing ultrasound transmission and potentially creating an acoustic window. We report a technical observation in which lung consolidation enabled clear visualization of mediastinal vessels during point‐of‐care ultrasound (POCUS). An 89‐year‐old patient admitted to the intensive care unit developed respiratory failure and required invasive mechanical ventilation. Lung ultrasound demonstrated a left lower lobe consolidation interpreted as hospital‐acquired pneumonia. Using a convex transducer (2–5 MHz) with an abdominal preset positioned between the second and third left intercostal space, an axial mediastinal imaging plane was obtained through the consolidated lung. This view allowed visualization of the main pulmonary artery and its bifurcation, as well as the ascending and descending thoracic aorta and the superior vena cava. This observation highlights how lung consolidation may serve as an acoustic window, potentially expanding the diagnostic capabilities of transthoracic POCUS for mediastinal vascular assessment.