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Updated: Aug 6, 2026
Acute Myocardial Infarction in Rats
Published on: February 16, 2011
McConnell's Sign in an RV Infarct: A Case Report
Ethan Fernandes1,2, Wai Chung Tse3, Manuja Premaratne4
1Monash Health Melbourne Australia.
Background:
McConnell's sign on point-of-care ultrasound (POCUS) has traditionally been associated with acute pulmonary embolism (PE). However, current evidence suggests that McConnell's sign may not be as specific as commonly thought.
Key Findings:
We present the case of an 85-year-old gentleman presenting to the emergency department (ED) with clinical features and ECG findings consistent with acute right ventricular myocardial infarction (RVMI). POCUS in the ED revealed McConnell's sign. Nevertheless, the patient was appropriately referred for percutaneous coronary intervention (PCI) to treat RVMI.
Discussion:
Had the treating team assumed that McConnell's sign was specific for PE, the patient might have been managed inappropriately, critically delaying coronary reperfusion through PCI. We argue that clinical teaching and guidelines should have greater emphasis on contextualising McConnell's sign with the clinical presentation in order to improve patient outcomes when making time-sensitive decisions. Additionally, the relationship between RV NSTEMI and McConnell's sign is yet to be explored in the available literature, and further research into this area could greatly improve diagnostic differentiation in the absence of regional ischaemia on ECG.
Insights
McConnell's sign on point-of-care ultrasound (POCUS) is not always indicative of pulmonary embolism (PE). This case highlights its presence in right ventricular myocardial infarction (RVMI), emphasizing the need for clinical context in diagnosis.
Area of Science:
- Cardiology
- Emergency Medicine
- Radiology
Background:
- McConnell's sign on point-of-care ultrasound (POCUS) is traditionally linked to acute pulmonary embolism (PE).
- Emerging evidence questions the high specificity of McConnell's sign for PE.
Purpose of the Study:
- To present a case where McConnell's sign was observed in a patient with acute right ventricular myocardial infarction (RVMI).
- To emphasize the importance of clinical context in interpreting POCUS findings, particularly McConnell's sign.
Main Methods:
- Case report of an 85-year-old male presenting with symptoms suggestive of RVMI.
- Point-of-care ultrasound (POCUS) was utilized, revealing McConnell's sign.
- The patient underwent percutaneous coronary intervention (PCI) for RVMI.
Main Results:
- POCUS demonstrated McConnell's sign in a patient diagnosed with acute RVMI, not PE.
- Timely diagnosis and referral for PCI were crucial for patient management.
Conclusions:
- McConnell's sign may not be exclusively indicative of PE and requires careful clinical correlation.
- Clinical guidelines should stress contextualizing POCUS findings with patient presentation to avoid diagnostic errors and treatment delays.
- Further research is needed to explore the association between RV NSTEMI and McConnell's sign for improved diagnostic accuracy.
