Echocardiography in pulmonary embolism.

概要

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Echocardiography was performed on 10 patients with suspected acute pulmonary embolism. In 3 patients with normal echocardiograms, the diagnosis was excluded by pulmonary angiography. Two with small emboli on angiography had a pulmonary arterial pressure≤35mmHg and normal echocardiograms. Five had an increased right ventricular end-diastolic dimension (RVEDD) and 4 had a left ventricular end-diastolic dimension (LVEDD) below normal or in low normal levels. The RVEDD/LVEDD ratio was increased in 4 patients, 3 of whom had paradoxical interventricular septal motion. The mitral valve E-F slope and left atrial dimension changed variably. The posterior aortic wall O-V excursion (PAW-OV-Ex) decreased in 5 and was correlated with LVEDD (r=+0.92, p<0.01) and the RVEDD/LVEDD ratio (r=-0.87, p<0.025). Follow-up echocardiography in 3 cases after recovery showed a decreased RVEDD/LVEDD ratio, normal septal motion and improved LVEDD and PAW-OV-Ex.The PAW-OV-Ex seems to mirror the abnormalities in volume changes of the left side of the heart resulting from pulmonary embolism. An entirely normal echocardiogram would be unlikely in the presence of a hemodynamically significant pulmonary embolism.
International Heart Journal刊行会の論文