Right Ventricular Dilatation on Bedside Echocardiography Performed by Emergency Physicians Aids in the Diagnosis of Pulmonary Embolism

Dresden, Scott M.; Mitchell, Patricia; Rahimi, L.M.; Leo, Megan; Rubin-Smith, Julia; Bibi, Salma; White, Laura F.; Langlois, Breanne K.; Sullivan, Alison; Carmody, Kristin

doi:10.1016/j.annemergmed.2013.08.016

Cited by 122 publications

(98 citation statements)

References 35 publications

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“…Whereas the sensitivity of echocardiography in proving right heart strain in shocked patients is very high (90%), it is only 25%-50% for pulmonary embolism (Dresden et al 2014). In case of a suspected pulmonary embolism, compression sonography of the leg veins is recommended.…”

Section: Pulmonary Thrombembolismmentioning

confidence: 99%

Ultrasound of the Pleurae and Lungs

Dietrich

Mathis²,

Cui

et al. 2015

Ultrasound in Medicine & Biology

121

107

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The value of ultrasound techniques in examination of the pleurae and lungs has been underestimated over recent decades. One explanation for this is the assumption that the ventilated lungs and the bones of the rib cage constitute impermeable obstacles to ultrasound. However, a variety of pathologies of the chest wall, pleurae and lungs result in altered tissue composition, providing substantially increased access and visibility for ultrasound examination. It is a great benefit that the pleurae and lungs can be non-invasively imaged repeatedly without discomfort or radiation exposure for the patient. Ultrasound is thus particularly valuable in follow-up of disease, differential diagnosis and detection of complications. Diagnostic and therapeutic interventions in patients with pathologic pleural and pulmonary findings can tolerably be performed under real-time ultrasound guidance. In this article, an updated overview is given presenting not only the benefits and indications, but also the limitations of pleural and pulmonary ultrasound.

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Section: Pulmonary Thrombembolismmentioning

confidence: 99%

Ultrasound of the Pleurae and Lungs

Dietrich

Mathis²,

Cui

et al. 2015

Ultrasound in Medicine & Biology

121

107

View full text Add to dashboard Cite

show abstract

“…McConnell sign has been reported to have high sensitivity and specificity for diagnosing acute pulmonary embolism, however, recent reports have shown a poor predictive value for diagnosis of acute pulmonary embolism [13]. ECG showed S1Q3T3 which is not neither sensitive nor specific for pulmonary embolism with the most common finding being sinus tachycardia.…”

Section: Discussionmentioning

confidence: 86%

Is 20s too young to have triple coronary vessel disease?

Umair¹,

Alkhawam²,

Zaiem³

et al. 2015

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Computed tomography angiography (CTA) was also done which was negative for any acute pulmonary embolism, and anticoagulation was discontinued in the light of negative CTA. The patient was discharged from hospital with follow-up in outpatient department. However, the patient came back to emergency department with worsening dyspnea. Lab work was significant for elevated troponin I and ECG on admission showed normal sinus rhythm and S1Q3T3 pattern. Patient had coronary angiography which showed three vessel disease. IJCRI publishes Conclusion:Smoking is conventionally recognized as the most common risk factor for heart disease. The CAD in young adults has a poor long-term prognosis. Smoking cessation remains a significant challenge in younger population. More awareness and cessation measures are required to address this emerging situation. Given lack of warning signs in these patients, physicians need to be more aggressive in managing risk factors as CAD in younger patient can have adverse outcomes.

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“…Some retrospective or prospective studies even confirmed a 100% specificity of PE diagnosis using McConnell's sign. [3] However, a later study compared the imaging of patients with PE and patients with right ventricular infarction only to find that there was no statistical significance in the incidence of McConnell's sign between those two groups. [4] Another retrospective study showed that with all the patients showing McConnell's sign, only half of them were proved to have PE at last.…”

Section: Goal-oriented Multiorgan Poc Ultrasonographymentioning

confidence: 99%

Clinical value of ultrasonography in diagnosis of pulmonary embolism in critically ill patients

Zhu

2017

Journal of Translational Internal Medicine

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Pulmonary embolism (PE) is a clinical emergency that will increase the mortality if complicated with unstable hemodynamics. Because of its nonspecific clinical symptoms, it's a great challenge to make a PE diagnosis. The golden standard to diagnose PE is computed tomography of pulmonary artery (CTPA), but a diagnosis of PE also composed of evaluation of PE risk factors, possibilities, and risk stratification. Ultrasonography may detect right ventricle strain related to hemodynamic change, intravascular thrombosis, thrombosis in right heart or pulmonary arteries, pulmonary infarction, and local pleural effusion. Combination of ultrasound and traditional PE possibility evaluation score may further improve the pretest probability of CTPA. A comprehensive ultrasonography may sometimes rule out PE and may disclose other causes for the clinical situations. A heart-lung-vessel-integrated multiorgan ultrasonography can help with the diagnosis of PE and so should be a necessary weapon for the physicians.

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Right Ventricular Dilatation on Bedside Echocardiography Performed by Emergency Physicians Aids in the Diagnosis of Pulmonary Embolism

Cited by 122 publications

References 35 publications

Ultrasound of the Pleurae and Lungs

Ultrasound of the Pleurae and Lungs

Is 20s too young to have triple coronary vessel disease?

Clinical value of ultrasonography in diagnosis of pulmonary embolism in critically ill patients

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