Echocardiography in Pulmonary Embolism

Summary

Echocardiography has emerged as an important and unique diagnostic tool in patients with acute pulmonary embolism (PE). In addition to occasionally providing direct visualization of thrombus within the right-sided chambers and pulmonary arteries, echocardiography provides crucial information about cardiac function, particularly the function of the right ventricle. Exquisitely sensitive to changes in afterload, a previously normal right ventricle dilates and becomes dysfunctional in the setting of PE. Indeed, we have identified a specific pattern of right ventricular regional wall motion that is often present in patients with PE. In addition to providing important diagnostic information, these alterations in right ventricular morphology and function provide prognostic information as well, as patients who have evidence of right ventricular dysfunction have a higher incidence of death and recurrent PE. Echocardiography can be used to identify patients at high risk following PE and thus can be used to identify those patients who would most benefit from aggressive therapies, including thrombolysis, and open or suction embolectomy. Finally, echocardiography provides a unique insight into the pathophysiology of PE and the function of the right ventricle in pulmonary vascular disease.