Echocardiographic findings in pulmonary embolism: An important guide for the management of the patient

Abstract

Echocardiography can be used as an easy, inexpensive, devoid of complications and, for the most part, universally available tool for the risk stratification of patient with acute pulmonary embolism. Because of its low sensibility, an echocardiogram is best indicated in a patient in whom hypotension and or shock are suspected to be due to pulmonary embolism. Pertinent findings in the echocardiogram can justify the use of fibrinolytic therapy. Most common echocar-diographic findings in acute pulmonary embolism are: dilatation of the right ventricle, right ventricular dysfunction in some cases with preservation of the motility of the apex, dilatation of the inferior vena cava with lack of collapse during inspiration flattening of the interventricular septum suggesting right ventricular pressure overload and pulmonary hypertension based on the jet of tricuspid regurgitation if available.

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Cohen, R. , Loarte, P. , Navarro, V. and Mirrer, B. (2012) Echocardiographic findings in pulmonary embolism: An important guide for the management of the patient. World Journal of Cardiovascular Diseases, 2, 161-164. doi: 10.4236/wjcd.2012.23027.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Senior, R.M. (1996) Pulmonary embolism. In: Bennett, J.C., et al., Eds., Cecil Textbook of Medicine, 20th Edition, Saunders, Philadelphia, 422-429.
[2] Horlander, K.T., Mannino, D.M. and Leeper, K.V. (2003) Pulmonary embolism mortality in the United States, 1979-1998: An analysis using multiple-cause mortality data. Archives of Internal Medicine, 163, 1711-1717. doi:10.1001/archinte.163.14.1711
[3] Kelley, M.A., et al. (1991) Diagnosing pulmonary embolism: New facts and strategies. Annals of Internal Medicine, 114, 300-306.
[4] Ginghina, C., Caloianu, G.A., Serban, M. and Dragomir, D. (2010) Right ventricular myocardial infarction and pulmonary embolism differential diagnosis—A challenge for the clinician. Journal of Medicine and Life, 3, 242-253.
[5] Mookadam, F., Jiamsripong, P., Goel, R., Warsame, T.A., Emani, U.R. and Khandheria, B.K. (2010) Critical appraisal on the utility of echocardiography in the management of acute pulmonary embolism. Cardiology in Review, 18, 29-37. doi:10.1097/CRD.0b013e3181c09443
[6] Hsiao, S.H., Lee, C.Y., Chang, S.M., Yang, S.H., Lin, S.K. and Huang, W.C. (2006) Pulmonary embolism and right heart function: Insights from myocardial Doppler tissue imaging. Journal of the American Society of Echocardiography, 19, 822-888. doi:10.1016/j.echo.2006.01.011
[7] Serafini, O., Greco, F., Misuraca, G., Chiatto, M., Buffon, A. (2005) Echocardiography in the diagnostic and prognostic evaluation of thromboembolic pulmonary hypertension. Archives for Chest Disease, 64, 116-123.
[8] Stawicki, S.P., Seamon, M.J., Meredith, D.M., Chovanes, J., Paszczuk, A., Kim, P.K. and Gracias, V.H. (2008) Transthoracic echocardiography for suspected pulmonary embolism in the intensive care unit: Unjustly underused or rightfully ignored? Journal of Clinical Ultrasound, 36, 291-302. doi:10.1002/jcu.20461
[9] Kearon, C. (2003) Diagnosis of pulmonary embolism. Canadian Medical Association Journal, 168, 183-194.
[10] Goldhaber, S.Z., Visani, L. and De Rosa, M. (1999) Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet, 353, 1386-1389. doi:10.1016/S0140-6736(98)07534-5
[11] Stein, P.D., et al. (2008) Enlarged right ventricle without shock in acute pulmonary embolism: Prognosis. American Journal of Medicine, 121, 134-142. doi:10.1016/j.amjmed.2007.06.032
[12] Goldhaber, S.Z. (2002) Echocardiography in the management of pulmonary embolism. Annals of Internal Medicine, 136, 691-700.
[13] O’Neill, J.O., Iqbal, R. and McGarry, K. (2002) Thrombus in transit—The role of echocardiography in the diagnosis of massive pulmonary embolism and a review of the literature. Acta Cardiologica, 57, 291-294.
[14] Leibowitz, D. (2001) Role of echocardiography in the diagnosis and treatment of acute pulmonary thromboembolism. Journal of the American Society of Echocardiography, 14, 921-926. doi:10.1067/mje.2001.114390
[15] Torbicki, A., Tramarin, R. and Morpurgo, M. (1992) Role of echo Doppler in the diagnosis of pulmonary embolism. Clinical Cardiology, 15, 805-810. doi:10.1002/clc.4960151104
[16] Bova, C., Greco, F., Misuraca, G., et al. (2003) Diagnostic utility of echocardiography in patients with suspected pulmonary embolism. American Journal of Emergency Medicine, 21, 180-183. doi:10.1016/S0735-6757(02)42257-7
[17] Stein, P.D., Hull, R.D. and Raskob, G. (1994) Risks for major bleeding from thrombolytic therapy in patients with acute pulmonary embolism: Consideration of noninvasive management. Annals of Internal Medicine, 121, 313-317.

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