Ultrasound in cardiovascular care: a perspective on preventive, diagnostic, and monitoring applications

Cardiovascular disease (CVD) remains the leading global cause of death, underscoring the need for improved strategies for early detection and prevention. Conventional risk models such as Framingham and SCORE estimate population-level risk but often fail to identify individuals with subclinical vascular damage. Atherosclerosis, the underlying cause of most CVDs, develops silently for decades, emphasizing the importance of imaging modalities capable of detecting early vascular changes. Ultrasound offers a safe, non-invasive, and radiation-free means to visualize vascular structure, function, and hemodynamics in real time. This perspective reframes ultrasound as a cornerstone of preventive and diagnostic vasculature medicine in general, and cardiovascular medicine in particular, emphasizing major modalities-point-of-care ultrasonography (POCUS), Doppler, Duplex, contrast-enhanced ultrasound (CEUS), elastography, and pulse wave velocity (PWV). These techniques enable early risk stratification, monitoring of atherosclerotic progression, and evaluation of therapeutic response across carotid, aortic, peripheral, coronary, cerebral, and renal arteries. Ultrasound also serves as a behavioral catalyst, enhancing patient awareness and engagement. However, widespread adoption requires standardized protocols, provider training, ethical oversight, and equitable implementation to avoid global disparities. Recent advances in artificial intelligence (AI), machine learning (ML), and deep learning (DL) are revolutionizing ultrasound by automating plaque quantification, improving reproducibility, and expanding access through portable and handheld systems. Cloud-based interpretation and telemedicine integration further extend cardiovascular screening into community and home settings. As ultrasound evolves into a frontline technology for prevention, diagnosis, and monitoring, its integration with AI-driven interpretation and mobile health platforms positions it as a pivotal tool in personalized and equitable cardiovascular care.