The value of echocardiography in the diagnostic work-up of patients with suspected acute pulmonary embolism

  • W. Kasper
  • S. Konstantinides
  • A. Geibel


Echocardiography can be used as a differential diagnostic procedure in the diagnostic workup of patients with clinically suspected pulmonary embolism. If RV pressure overload is ruled out in those patients, mortality from thrombembolism seems to be low irrespective of whether pulmonary embolism is present or absent. If, on the other hand, RV pressure overload is present, the prognosis is worse and is dependent on the presence of arterial hypotension at presentation and a patent foramen ovale. Clinicians no longer insist on definite confirmation of pulmonary embolism by nuclear imaging studies or pulmonary angiography especially if the patient is clinically unstable at presentation. It is, thus, evident that echocardiography has gained an important diagnostic position for the management of patients with suspected pulmonary embolism.


Pulmonary Embolism Right Ventricular Acute Pulmonary Embolism Pulmonary Angiography Massive Pulmonary Embolism 
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  1. 1.
    The European cooperative study on the clinical significance of right heart thrombi (1989) Eur Heart J 10: 1046–1059Google Scholar
  2. 2.
    Ginberg JS (1996) Management of venous thromboembolism. N Engl J Med 335:1816–1828CrossRefGoogle Scholar
  3. 3.
    Kasper W, Konstantinides S, Geibel A, Olschewski M, Heinrich F, Grosser KD, Rauber K, Iversen S, Redecker M, Kienast J (1997) Management strategies and determinants of outcome in acute major pulmonary embolism: Results of a multicenter registry. J Am Coll Cardiol 30:1165–1171PubMedCrossRefGoogle Scholar
  4. 4.
    Kasper W, Geibel A, Tiede N, Bassenge D, Kauder E, Konstantinides S, Meinertz T, Just H (1993) Distinguishing between acute and subacute massive pulmonary embolism by conventional and Doppler echocardiography. Br Heart J 70:352–356PubMedCrossRefGoogle Scholar
  5. 5.
    Kasper W, Geibel A, Tiede N, Just H (1992) Patent foramen ovale in patients with hemodynamically significant pulmonary embolism. Lancet 340:561–564PubMedCrossRefGoogle Scholar
  6. 6.
    Kasper W, Konstantinides S, Geibel A, Tiede N, Krause T, Just H (1997) Prognostic significance of right ventricular afterload stress detected by echocardiography in patients with clinically suspected pulmonary embolism. Heart 77:346–349PubMedGoogle Scholar
  7. 7.
    Kasper W, Meinertz T, Henkel T, Eissner D, Hahn K, Hofmann T, Zeiher A, Just H (1986) Echocardiographic findings in patients with proved pulmonary embolism. Am Heart J 112:1284–1290PubMedCrossRefGoogle Scholar
  8. 8.
    Konstantinides S, Geibel A, Kasper W (1996) Role of cardiac ultrasound in the detection of pulmonary embolism. Semin Respir Crit Care Med 17:39–49CrossRefGoogle Scholar
  9. 9.
    Konstantinides S, Geibel A, Kasper W, Olschewski M, Blümel L, Just H (1998) Patent foramen ovale is a major determinant of outcome in patients with massive pulmonary embolism. Circulation: in pressGoogle Scholar
  10. 10.
    Konstantinides S, Geibel A, Olschewski M, Kasper W, Just H (1997) Acute pulmonary embolism: The value of echocardiography for identification of high risk patients. Circulation 96:1–25 (Abstract)Google Scholar
  11. 11.
    Mark A, Kelley, Jeffrey L, Carson, Harold I, Palevsky J, Sanford Schwartz (1991) Diagnosing pulmonary embolism: New facts and strategies. Ann Int Med 114:300–306Google Scholar
  12. 12.
    Ribeiro A, Lindmarker P, Juhlin-Damfelt A, Johnsson H, Jorfeldt L (1997) Echocardiography Doppler in pulmonary embolism: Right ventricular dysfunction as a predictor of mortality rate. Am Heart J 134: 479–487PubMedCrossRefGoogle Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt 2000

Authors and Affiliations

  • W. Kasper
    • 1
  • S. Konstantinides
    • 2
  • A. Geibel
    • 2
  1. 1.Medizinische KlinikSt. Josefs-HospitalWiesbadenGermany
  2. 2.Abteilung Innere Medizin III, KardiologieUniversitätsklinik FreiburgFreiburgGermany

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