Acute right ventricular overload: an echocardiographic clue to pulmonary thromboembolism

Serial echocardiographic changes and angiographic correlation are presented in a patient with multiple pulmonary emboli. Interval development of right ventricular dilatation and paradoxical septal motion coincided with a clinical event which was proven angiographically to represent pulmonary thromboembolism. Echocardiographic findings suggested right ventricular pressure and/or volume overload. The differential diagnosis of this finding when acute is limited; pulmonary embolism is a prominent consideration. Echocardiography performed after the patient received anticoagulant therapy showed a complete return to normal. Echocardiographic evidence of right ventricular overload, particularly when acute, may indicate the presence of a pulmonary embolism, and may be clinically useful in selected cases.