Echocardiogram Findings in Pulmonary Embolism

Echocardiogram Findings in Pulmonary Embolism


Echocardiogram Findings in Pulmonary Embolism


# Echocardiogram Findings in Pulmonary Embolism- Key Points
1McConnell’s sign is specific for PE
RV free wall hypokinesia with apical sparing is seen in acute PE.
2Flattened interventricular septum indicates RV overload
Seen in parasternal short-axis view; caused by RV pressure overload.
3Right ventricular dilation is common in PE
Acute PE causes sudden pressure overload and RV chamber dilation.
4TR jet velocity >2.8 m/s indicates PH
High TR velocity reflects elevated pulmonary artery pressure.
5TAPSE <16 mm suggests RV dysfunction
TAPSE is a surrogate marker of RV longitudinal function.
6D-shaped LV in short axis = RV pressure overload
Due to septal shift during systole; seen in parasternal short-axis view.
7McConnell’s sign indicates acute (not chronic) RV strain
Helps differentiate acute PE from chronic pulmonary hypertension.
8IVC dilation without collapse = elevated RA pressure
Dilated IVC with < 50% inspiratory collapse suggests high right atrial pressure.
9RA/RV thrombus on echo suggests high embolic risk
TEE more sensitive than transthoracic echo for thrombi.
10RV:LV ratio > 1:1 indicates RV strain
Best seen in apical four-chamber view; indicates significant RV pressure overload.
11Mid-systolic notch on Doppler indicates pulmonary hypertension
Notch is seen on RVOT pulsed Doppler waveform.
12Reduced tricuspid S’ velocity suggests RV dysfunction
S’ < 10 cm/s measured by tissue Doppler.
13Septal flattening = RV pressure overload
Seen in systole on short-axis view; bowing toward LV.
14RV free wall motion abnormalities reflect dysfunction
Seen on 2D echo; especially apical views.
15RV hypertrophy suggests chronic rather than acute pressure overload
Helps distinguish chronic PH from acute PE.
16TEE is best for RA thrombus visualization
Provides higher resolution images of cardiac chambers.
17McConnell’s sign is more specific than sensitive
Highly specific but not always present in all PE cases.
18Reduced RV strain indicates worsening RV function
Measured via strain imaging in advanced echo settings.
19RV apical sparing is unique to McConnell’s sign
Basal hypokinesia with apical preservation is characteristic.
20Severe RV dilation and paradoxical septal motion = pre-collapse
Indicates RV failure and high risk of hemodynamic collapse.

Echocardiogram Findings in Pulmonary Embolism


  1. McConnell’s sign is specific for PE
    RV free wall hypokinesia with apical sparing is seen in acute PE.
  2. Flattened interventricular septum indicates RV overload
    Seen in parasternal short-axis view; caused by RV pressure overload.
  3. Right ventricular dilation is common in PE
    Acute PE causes sudden pressure overload and RV chamber dilation.
  4. TR jet velocity >2.8 m/s indicates PH
    High TR velocity reflects elevated pulmonary artery pressure.
  5. TAPSE <16 mm suggests RV dysfunction
    TAPSE is a surrogate marker of RV longitudinal function.
  6. D-shaped LV in short axis = RV pressure overload
    Due to septal shift during systole; seen in parasternal short-axis view.
  7. McConnell’s sign indicates acute (not chronic) RV strain
    Helps differentiate acute PE from chronic pulmonary hypertension.
  8. IVC dilation without collapse = elevated RA pressure
    Dilated IVC with < 50% inspiratory collapse suggests high right atrial pressure.
  9. RA/RV thrombus on echo suggests high embolic risk
    TEE more sensitive than transthoracic echo for thrombi.
  10. RV:LV ratio > 1:1 indicates RV strain
    Best seen in apical four-chamber view; indicates significant RV pressure overload.
  11. Mid-systolic notch on Doppler indicates pulmonary hypertension
    Notch is seen on RVOT pulsed Doppler waveform.
  12. Reduced tricuspid S’ velocity suggests RV dysfunction
    S’ < 10 cm/s measured by tissue Doppler.
  13. Septal flattening = RV pressure overload
    Seen in systole on short-axis view; bowing toward LV.
  14. RV free wall motion abnormalities reflect dysfunction
    Seen on 2D echo; especially apical views.
  15. RV hypertrophy suggests chronic rather than acute pressure overload
    Helps distinguish chronic PH from acute PE.
  16. TEE is best for RA thrombus visualization
    Provides higher resolution images of cardiac chambers.
  17. McConnell’s sign is more specific than sensitive
    Highly specific but not always present in all PE cases.
  18. Reduced RV strain indicates worsening RV function
    Measured via strain imaging in advanced echo settings.
  19. RV apical sparing is unique to McConnell’s sign
    Basal hypokinesia with apical preservation is characteristic.
  20. Severe RV dilation and paradoxical septal motion = pre-collapse
    Indicates RV failure and high risk of hemodynamic collapse

    Subscribe Medicine Question BankWhatsApp Channel

    FREE Updates, MCQs & Questions For Doctors & Medical Students

      Medicine Question Bank
      Enable Notifications OK No thanks