Echocardiography in the Evaluation of Pulmonary Embolism

Pulmonary embolism is a major cause of mortality. Acute pulmonary embolism also encompasses a wide clinical spectrum of severity, ranging from asymptomatic silent disease to hemodynamic instability and shock. Echocardiography is a useful modality to improve treatment strategies for pulmonary embolus. Echocardiography plays a role in risk stratification at the time of diagnosis. The evaluation of the right ventricle (RV) has evolved over time. RV variables evaluated by echocardiography include RV size, RV/left ventricular ratio, RV fractional area of change, tricuspid annular plane systolic excursion, RV systolic pressure, and RV Tei index. It has also been used in determining treatment strategies and following the success of treatment. Multiple echocardiographic criteria have been studied to improve risk stratification and outcomes from pulmonary embolism. Further studies are needed to assess the appropriate quantitative echocardiographic parameters.