J Cardiovasc Ultrasound.  2008 Mar;16(1):9-16. 10.4250/jcu.2008.16.1.9.

Role of Echocardiography in Patients with Acute Pulmonary Thromboembolism

• Lee JH
• Park JH

• KMID: 1486604
• DOI: http://doi.org/10.4250/jcu.2008.16.1.9

Abstract

Acute pulmonary thromboembolism (PTE) is a common problem. In the emergency room, a substantial number of patients with chest discomfort have had an acute PTE. Presently, accepted diagnostic modalities for the confirmation of PTE include ventilation/perfusion (V/Q) scanning, chest computed tomography (CT), and standard angiography. However, each modality has important limitations. Although chest CT scanning has for the most part replaced lung scanning as the main diagnostic test for PTE, transthoracic echocardiography (TTE) is a noninvasive modality providing rapid results at the bedside. As well as being noninvasive modality, TTE avoids the contrast and radiation hazards of chest CT or conventional angiography. Thus echocardiography is an attractive imaging modality to diagnose PTE. TTE allows visualization of the aorta and the LV to evaluate for other etiologies of chest pain. Besides giving important diagnostic information, TTE can aid prediction of prognosis. Presence of RV dilatation and dysfunction is a poor prognostic sign and is the indicator for thrombolytic therapy. However, TTE has some limitations including poor imaging quality depending on the acoustic window and has a low sensitivity in detecting PTE.

Keyword

Echocardiography; Transthoracic; Diagnosis; Pulmonary thromboembolism

MeSH Terms

Acoustics
Angiography
Aorta
Chest Pain
Diagnostic Tests, Routine
Dilatation
Echocardiography
Emergencies
Humans
Lung
Prognosis
Pulmonary Embolism
Thorax
Thrombolytic Therapy