Diagnostic use of emergency department echocardiogram in massive pulmonary emboli

Massive pulmonary embolism represents a small percentage of patients presenting to the emergency department with clinical symptoms suggestive of embolic phenomenon. Definitive therapy with thrombolytics or embolectomy is usually delayed until angiographic verification of the clinical suspicion can be obtained. A case is described in which embolectomy was based on clinical diagnosis and confirmatory echocardiogram obtained in the ED. The rapid diagnostic role of echocardiographic data in a subset of patients presenting with clinical symptoms suggestive of massive pulmonary emboli deserves further evaluation.