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[Ultrasound in the diagnosis of thromboembolism]
P Vahala1, P Poliacik, J Daniska
1Vnitrní oddĕlení I. NsP Nitra.
Insights
Early diagnosis of thromboembolic attacks is crucial. Echocardiography and duplex ultrasound of lower extremities help detect conditions like deep vein thrombosis and pulmonary embolism, enabling prompt treatment.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Thromboembolic attacks pose significant health risks.
- Early diagnosis is essential for effective treatment and improved patient outcomes.
- Distinguishing between various causes of patient complaints is critical.
Purpose of the Study:
- To review the importance of echocardiography and lower extremity duplex examination for diagnosing thromboembolic attacks.
- To highlight the role of echocardiography in ruling out other cardiac conditions.
- To emphasize the combined utility of echocardiography and duplex sonography for prompt treatment initiation.
Main Methods:
- Echocardiography to assess cardiac function and rule out alternative diagnoses.
- Duplex sonography for evaluating lower extremity blood vessels and detecting deep venous thrombosis.
- Doppler assessment of right heart pressures via tricuspidal regurgitation.
Main Results:
- Echocardiography identifies right heart strain (pulmonary artery and right ventricle dilatation in 75% of patients).
- Duplex sonography demonstrates high sensitivity (95-100%) and specificity for acute deep venous thrombosis.
- Combined echocardiography and duplex sonography facilitate prompt treatment in 70-80% of patients.
Conclusions:
- Echocardiography and lower extremity duplex examination are vital for early thromboembolic attack diagnosis.
- These imaging modalities aid in identifying pulmonary embolism and deep venous thrombosis.
- Concurrent use of these methods improves treatment timeliness for a majority of patients.
Abstract:
The authors review the importance of echocardiography and duplex examination of the blood vessels of the lower extremities for early diagnosis of thromboembolic attacks. Echocardiographic examination rules out other causes of the patient's complaints such as myocardial infarction, heart defects, ischaemic heart disease and others. The main role of echocardiography is, however, detection of symptoms of an acute rise of the blood pressure in the right heart or symptoms of its failure. The most valuable symptom is dilatation of the right branch of the pulmonary artery and dilatation of the right ventricle found in as many as 75% patients. It is also useful to assess by the Doppler method the dextrolateral systolic pressure from tricuspidal regurgitation. For pulmonary embolism a regurgitation rate of 2.8-3.8 m/s is typical. The correlation coefficient is, however, lower than when the dimensions of the right and left ventricle are used. Evidence of deep venous thrombosis does not reveal pulmonary embolism but has the same therapeutic consequences. Duplex sonography has a 95-100% sensitivity and specificity in acute thrombosis. In recurrent thrombosis it is necessary to use a combination of the two methods. Concurrent echocardiography and duplex sonography of the blood vessels of the lower extremities makes it possible to start prompt treatment in 70-80% of the patients. In the remainder for diagnosis of thromboembolic attacks other methods must be used.