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[Echocardiography in pulmonary embolism]

M P Augusseau-Richard1, G Pacouret, X Dessenne

  • 1Service de cardiologie, CHU Trousseau, Tours.

Archives Des Maladies Du Coeur Et Des Vaisseaux
|November 1, 1995
PubMed
Summary

Transthoracic echocardiography can reveal signs of pulmonary embolism, such as right heart enlargement. Transesophageal echocardiography is effective for diagnosing proximal pulmonary embolism, guiding treatment decisions.

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Area of Science:

  • Cardiology
  • Radiology
  • Pulmonary Medicine

Background:

  • Pulmonary embolism (PE) diagnosis often relies on imaging, but direct visualization of thrombi is rare with transthoracic echocardiography (TTE).
  • Acute pulmonary hypertension secondary to PE causes characteristic echocardiographic findings.

Purpose of the Study:

  • To evaluate the diagnostic utility of echocardiography in assessing pulmonary embolism severity.
  • To compare transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) for PE diagnosis and management.

Main Methods:

  • Utilized transthoracic echocardiography (TTE) to identify morphological and Doppler abnormalities indicative of acute pulmonary hypertension.
  • Employed transesophageal echocardiography (TEE) for sensitive and specific detection of proximal emboli in massive PE.
  • Assessed right/left ventricular dimension ratio and interventricular septal contraction patterns.

Main Results:

  • TTE can indicate severe PE through right heart chamber dilatation (RV/LV dimension ratio > 0.6) and abnormal septal contraction.
  • TEE is a sensitive and specific bedside tool for diagnosing proximal PE in two-thirds of massive PE cases.
  • Doppler echocardiography aids in monitoring hemodynamic changes and regression of acute cor pulmonale post-thrombolysis.

Conclusions:

  • Echocardiography, particularly TEE, is valuable for diagnosing and assessing the severity of pulmonary embolism.
  • TEE facilitates rapid diagnosis and treatment initiation (thrombolysis or surgery) for massive PE, potentially avoiding pulmonary angiography.
  • Echocardiography is useful for post-treatment follow-up of hemodynamic status.

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