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McConnell in Shock.

Joana Silva Marques¹, Rui Correia¹, Joana Correia²

¹Internal Medicine, Centro Hospitalar Tondela-Viseu, Epe, Viseu, PRT.

|July 30, 2021

Summary

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Point-of-care ultrasound (POCUS) rapidly identifies shock causes in unstable patients. Echocardiography revealed McConnell sign, indicating obstructive shock from pulmonary embolism before other tests.

Area of Science:

Critical Care Medicine
Emergency Medicine
Cardiology

Background:

Hemodynamically unstable patients require rapid diagnosis of shock etiology for timely intervention.
Challenges in critically ill patients include limited data, broad differentials, and urgent treatment needs.
Point-of-care ultrasound (POCUS) offers a non-invasive, real-time bedside tool for assessing unstable patients.

Observation:

A case study involving a patient presenting with hemodynamic instability.
Bedside echocardiography was utilized for rapid patient assessment.
The patient was diagnosed with obstructive shock secondary to pulmonary embolism.

Findings:

McConnell sign, a specific echocardiographic finding, was identified.
This sign indicated right ventricular strain consistent with pulmonary embolism.

Keywords:

fibrinolysis massive pulmonary embolism mcconnell sign obstructive shock point-of-care-ultrasound

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Diagnosis was established via POCUS prior to definitive imaging (CTPA) and laboratory results.

Implications:

POCUS can expedite the diagnosis of obstructive shock in hemodynamically unstable patients.
Early identification of McConnell sign via echocardiography can guide immediate management decisions.
Bedside ultrasound is invaluable for critically ill patients too unstable for conventional diagnostic pathways.