Shape-based analysis of right ventricular dysfunction associated with acute pulmonary embolism

2012 ◽  
Author(s):  
Nima Tajbakhsh ◽  
Wenzhe Xue ◽  
Hong Wu ◽  
Jianming Liang ◽  
Eileen M. McMahon ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Right Ventricular ◽  
Acute Pulmonary Embolism ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction

McConnell’s Sign As An indicator of Right Ventricular Infarction: A Case Report

2021 ◽  
Author(s):  
Judah Nijas Arul ◽  
Preetam Krishnamurthy ◽  
Balakrishnan Vinod Kumar ◽  
Thoddi Ramamurthy Muralidharan ◽  
Senguttuvan Nagendra Boopathy ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Right Ventricular ◽  
Medical Management ◽  
Acute Pulmonary Embolism ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Right Ventricular Infarction ◽  
Coronary Syndrome ◽  
Pulmonary Angiogram ◽  
Ventricular Infarction

Abstract BackgroundMcConnell’s sign is a specific echocardiographic finding that was first described in patient with acute pulmonary embolism signifying right ventricular dysfunction. It remains an under-recognized sign in patients with right ventricular infarction.Case PresentationAn 80-year-old woman presented with sudden onset chest pain and breathlessness. The electrocardiogram showed features suggestive of inferior, posterior, and right ventricular infarction with complete heart block and McConnell’s sign was seen on the echocardiography. CT pulmonary angiogram ruled out the present of pulmonary thromboembolism. Coronary angiogram revealed an occluded right coronary artery with collateral supply from the left circulation. Medical management was planned after patient-physician discussion. Patient symptomatically improved with medical management.ConclusionAlthough McConnell’s sign is suggestive of acute pulmonary embolism, it may also be present in patients with right ventricular dysfunction due to infarction. The presence of McConnell’s sign in a patient presenting with acute coronary syndrome should prompt evaluation for right ventricular infarction in the absence of acute pulmonary embolism.

scholarly journals Risk stratification in normotensive acute pulmonary embolism patients: focus on the intermediate–high risk subgroup

2019 ◽  
Vol 9 (4) ◽  
pp. 279-285 ◽  
Author(s):  
Ana Rita Santos ◽  
Pedro Freitas ◽  
Jorge Ferreira ◽  
Afonso Oliveira ◽  
Mariana Gonçalves ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Risk Stratification ◽  
Right Ventricular ◽  
Acute Pulmonary Embolism ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Cardiac Biomarkers ◽  
Cardiac Biomarker ◽  
Imaging Signs

Background: Patients with acute pulmonary embolism are at intermediate–high risk in the presence of imaging signs of right ventricular dysfunction plus one or more elevated cardiac biomarker. We hypothesised that intermediate–high risk patients with two elevated cardiac biomarkers and imaging signs of right ventricular dysfunction have a worse prognosis than those with one cardiac biomarker and imaging signs of right ventricular dysfunction. Methods: We analysed the cumulative presence of cardiac biomarkers and imaging signs of right ventricular dysfunction in 525 patients with intermediate risk pulmonary embolism (intermediate-high risk = 237) presenting at the emergency department in two centres. Studied endpoints were composites of all-cause mortality and/or rescue thrombolysis at 30 days (primary endpoint; n=58) and pulmonary embolism-related mortality and/or rescue thrombolysis at 30 days (secondary endpoint; n=40). Results: Patients who experienced the primary endpoint showed a higher proportion of elevated troponin (47% vs. 76%, P<0.001), elevated N-terminal pro-brain natriuretic peptide (67% vs. 93%, P<0.001) and imaging signs of right ventricular dysfunction (47% vs. 80%, P<0.001). Multivariate analysis revealed N-terminal pro-brain natriuretic peptide (hazard ratio (HR) 3.6, 95% confidence interval (CI) 1.3–10.3; P=0.015) and imaging signs of right ventricular dysfunction (HR 2.8, 95% CI 1.5–5.2; P=0.001) as independent predictors of events. In the intermediate–high risk group, patients with two cardiac biomarkers performed worse than those with one cardiac biomarker (HR 3.3, 95% CI 1.8–6.2; P=0.003). Conclusions: Risk stratification in normotensive pulmonary embolism should consider the cumulative presence of cardiac biomarkers and imaging signs of right ventricular dysfunction, especially in the intermediate–high risk subgroup.

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