Echocardiography in pulmonary embolism

Echocardiography in pulmonary embolism Brief Review Echocardiography in acute pulmonary embolism is useful in several ways. Visualization of thrombi within the right heart or pulmonary arteries would be the most direct way of diagnosing acute pulmonary embolism by echocardiography. Mobile thrombi in the right heart detected during echocardiography also carries a poor prognosis with higher association with right ventricular dysfunction and mortality. In general, the chance of detection of mobile right heart thrombi in acute pulmonary embolism is about four percent, though up to eighteen percent have been detected in certain intensive care settings. Trans esophageal echo can detect thrombi in central pulmonary arteries as well. Hence it may be a useful investigation when patient is too unstable to be shifted for computerized tomographic pulmonary angiography [1,2]. Other group of echocardiographic findings in acute pulmonary embolism are features of right ventricular overload due to sudden rise in pulmonary arterial pressure and right ventricular dysfunction. Tricuspid regurgitation jet velocity is useful to calculate the right ventricular systolic pressure by the Bernoulli equation (P = 4V2). Main pulmonary artery, right ventricle, right atrium and inferior vena cava can be seen to be dilated in acute pulmonary embolism. Right ventricular dilatation manifests as an increased RV-LV diameter ratio (RV: right ventricle; LV: left ventricle). Relative sparing of right ventricular a...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Echocardiography Source Type: blogs