Category: Visual Diagnosis
79 y.o. male lung cancer patient with tachypnea, tachycardia, and normal blood pressure. Click here: http://vimeo.com/27973006
Answer: Right ventricular (RV) dysfunction secondary to submassive pulmonary embolism (PE).
Ultrasound for suspected PE
Consider bedside echo with PE and elevated troponin or BNP.
Recall the classes of PE:
Ultrasound “clues” of submassive / massive PE:
Lodato JA, Parker Ward RP, Lang RM. Echocardiographic Predictors of Pulmonary Embolism in Patients Referred for Helical CT. Echocardiography 2008;25:584-590.
McConnell MV, Solomon SD, Rayan ME, et. al. Regional Right Ventricular Dysfunction Detected by Echocardiography in Acute Pulmonary Embolism. Am J Cardiol. 1996; 78: 469-473.
ACEP. Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Suspected Pulmonary Embolism. http://www.acep.org/content.aspx?id=30060. [July 24, 2011].
John Griffiths. Respiratory: Management of small, submassive and massive pulmonary embolism. http://www.frca.co.uk/article.aspx?articleid=100750. [July 24, 2011].
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