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Semin Respir Crit Care Med 2017; 38(01): 018-028
DOI: 10.1055/s-0036-1597563
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Echocardiography in the Risk Assessment of Acute Pulmonary Embolism

Talal Dahhan
1   Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Duke University, Durham, North Carolina
,
Fawaz Alenezi
2   Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina
,
Zainab Samad
2   Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina
,
Sudarshan Rajagopal
2   Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina
› Author Affiliations
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Publication History

Publication Date:
16 February 2017 (online)

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Abstract

Acute pulmonary embolism (PE) is a major cause of morbidity and mortality and is classified as massive (high risk), submassive (intermediate risk), or nonmassive (low risk) based on the hemodynamic status and clinical characteristics of the patient. At this time, the management of patients with submassive PE remains controversial and approaches for improving risk assessment are critical. In this review, we discuss several echocardiographic methods to assess right heart function that may aid in the risk assessment of patients with acute PE. They range from qualitative assessments of right ventricular (RV) function, such as subjective RV function and McConnell sign, to more recently developed quantitative parameters of RV function, such as tricuspid annular plane systolic excursion, RV/left ventricular ratio, and RV global and free wall longitudinal strain. Because of their reproducibility and objective nature, quantitative RV echocardiographic assessments have been gaining importance in the assessment of acute PE. Current limitations to the use of echocardiography for risk assessment in acute PE are the lack of normative values for RV parameters, the absence of standardization of measurements across different ultrasound platforms, and the heterogeneity of the performance of echocardiographic examinations and reports across centers.

Keywords

pulmonary embolism - echocardiography - right ventricle
 

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