Echocardiographic Pattern of Acute Cor Pulmonale

Jardin, François; Dubourg, Olivier; Bourdarias, Jean-Pierre

doi:10.1378/chest.111.1.209

Cited by 391 publications

(207 citation statements)

References 29 publications

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“…The RV fractional area change in the apical four-chamber view is decreased. An RV/LV area ratio ranging from 0.6-1 indicates mild RV dilation, while severe RV dilation is associated with a ratiow1 [111]. The RV function may be indirectly estimated by using the global RV function index and the velocity of the tricuspid annulus plane.…”

Section: Right Ventricular Functionmentioning

confidence: 99%

“…PH results in RV systolic overload characterised by leftward septal shift at end-systole and early diastole, the septum behaving has an intrinsic part of the RV [32,111]. RV geometric changes influence LV function, and prolonged LV isometric relaxation, reduction in LV early diastolic filling and paradoxic septal motion in systole are also observed [32,111].…”

Section: Interventricular Septum and Left Ventricle Functionmentioning

confidence: 99%

“…RV geometric changes influence LV function, and prolonged LV isometric relaxation, reduction in LV early diastolic filling and paradoxic septal motion in systole are also observed [32,111]. Deceleration time of early transmitral flow is decreased and negatively correlates with LV deformity index and PVR [115].…”

Section: Interventricular Septum and Left Ventricle Functionmentioning

confidence: 99%

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Haemodynamic evaluation of pulmonary hypertension

Chemla¹,

Castelain²,

Hervé³

et al. 2002

Eur Respir J

304

185

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Haemodynamic evaluation of pulmonary hypertension. D. Chemla, V. Castelain, P. Hervé, Y. Lecarpentier, S. Brimioulle. #ERS Journals Ltd 2002. ABSTRACT: Pulmonary hypertension is characterised by the chronic elevation of pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) leading to right ventricular enlargement and hypertrophy. Pulmonary hypertension may result from respiratory and cardiac diseases, the most severe forms occurring in thromboembolic and primary pulmonary hypertension.Pulmonary hypertension is most often defined as a mean PAP w25 mmHg at rest or w30 mmHg during exercise, the pressure being measured invasively with a pulmonary artery catheter. Doppler echocardiography allows serial, noninvasive follow-up of PAPs and right heart function. When the adaptive mechanisms of right ventricular dilatation and hypertrophy cannot compensate for the haemodynamic burden, right heart failure occurs and is associated with poor prognosis.The haemodynamic profile is the major determinant of prognosis. In both primary and secondary pulmonary hypertension, special attention must be paid to the assessment of pulmonary vascular resistance index (PVRI), right heart function and pulmonary vasodilatory reserve.Recent studies have stressed the prognostic values of exercise capacity (6-min walk test), right atrial pressure, stroke index and vasodilator challenge responses, as well as an interest in new imaging techniques and natriuretic peptide determinations. Overall, careful haemodynamic evaluation may optimise new diagnostic and therapeutic strategies in pulmonary hypertension.

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Section: Right Ventricular Functionmentioning

confidence: 99%

Section: Interventricular Septum and Left Ventricle Functionmentioning

confidence: 99%

Section: Interventricular Septum and Left Ventricle Functionmentioning

confidence: 99%

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Haemodynamic evaluation of pulmonary hypertension

Chemla¹,

Castelain²,

Hervé³

et al. 2002

Eur Respir J

304

185

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“…This often produces the echocardiographic findings of RV dilatation and hypokinesis, abnormal motion of the interventricular septum, tricuspid regurgitation, and plethora of the inferior vena cava. 5 It is not surprising that our patient exhibited these echocardiographic findings given his large bilateral pulmonary emboli. Of note, our patient had global dysfunction of the RV free wall, and the RV apex was not spared.…”

Section: Discussionmentioning

confidence: 60%

“…[2][3][4] Echocardiography can be useful in the diagnosis and management of PE and its complications. [5][6][7] We present a case of PE associated with RV dysfunction complicated by a paradoxical embolus in situ. Echocardiography was central to diagnosing this complication, and information from the echocardiogram altered treatment.…”

Section: Introductionmentioning

confidence: 99%

A case of paradoxical embolism “in situ” associated with massive pulmonary embolism: Role of echocardiography

Sumner¹,

Henderson²,

Martin³

et al. 2004

Clinical Cardiology

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Summary:A 49-year-old man was admitted in transfer for further management of a pulmonary embolism (PE) and possible mitral valve vegetation. Transthoracic echocardiography performed at our institution showed evidence of right ventricular (RV) enlargement and dysfunction. Within the right atrium was a serpentine mobile thrombus which traversed the interatrial septum at the level of the fossa ovalis and extended into the left atrium to the level of the anterior mitral valve leaflet. Because of the patient's dyspnea, RV dysfunction, and large clot burden, thrombolytic therapy was considered and would have been administered had the thrombus in situ not been identified. In light of the thrombus in situ and the concern about possible systemic embolization with thrombolytic therapy, the patient underwent successful surgical thrombectomy. This case highlights the importance of echocardiography in the management of patients with PE. We believe that all patients should undergo echocardiography prior to receiving thrombolytic therapy for pulmonary emboli. Careful interrogation of the interatrial septum for the presence of a thrombus in situ is warranted. Thrombectomy should be considered in individuals with PE who have a thrombus in situ.

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