McConnell Sign in a Patient with Massive Acute Pulmonary Embolism

Shafiq, Qaiser; Assaly, Ragheb; Kanjwal, Yousuf

doi:10.1155/2011/201097

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Some studies cite a functional ischemia of the RV as the underlying unifying mechanism 7 . Also noteworthy is that these proposed mechanisms may not be prevalent until later in the pathophysiological continuum, representing relatively late findings when greater than 25% of the flow‐through pulmonary vasculature is already obstructed 8,9 …”

Section: Discussionmentioning

confidence: 99%

McConnell's sign: Echocardiography in the management of acute pulmonary embolism

Patel

Miles

Shahangian

et al. 2021

Clinical Case Reports

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Management of acute pulmonary embolism depends immensely on rapid diagnosis and early intervention. Transthoracic echocardiography has gained favorability in scenarios where diagnostic computed tomography angiography is not feasible. McConnell's sign, an echocardiographic finding of segmental right ventricular wall‐motion abnormality with apical sparing, is highly specific and may guide therapeutic intervention. We present the case of a 59‐year‐old man who was found to have acute pulmonary embolism with obstructive shock, managed successfully with thrombolytic therapy after identification of McConnell's sign. We review current literature and develop a framework for the integration of echocardiography into the multimodal approach to management.

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Section: Discussionmentioning

confidence: 99%

McConnell's sign: Echocardiography in the management of acute pulmonary embolism

Patel

Miles

Shahangian

et al. 2021

Clinical Case Reports

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Dilemmas in the Choice of Adequate Therapeutic Treatment in Patients with Acute Pulmonary Embolism—From Modern Recommendations to Clinical Application

et al. 2022

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Pulmonary thromboembolism is a very common cardiovascular disease, with a high mortality rate. Despite the clear guidelines, this disease still represents a great challenge both in diagnosis and treatment. The heterogeneous clinical picture, often without pathognomonic signs and symptoms, represents a huge differential diagnostic problem even for experienced doctors. The decisions surrounding this therapeutic regimen also represent a major dilemma in the group of patients who are hemodynamically stable at initial presentation and have signs of right ventricular (RV) dysfunction proven by echocardiography and positive biomarker values (pulmonary embolism of intermediate–high risk). Studies have shown conflicting results about the benefit of using fibrinolytic therapy in this group of patients until hemodynamic decompensation, due to the risk of major bleeding. The latest recommendations give preference to new oral anticoagulants (NOACs) compared to vitamin K antagonists (VKA), except for certain categories of patients (patients with antiphospholipid syndrome, mechanical valves, pregnancy). When using oral anticoagulant therapy, special attention should be paid to drug–drug interactions, which can lead to many complications, even to the death of the patient. Special population groups such as pregnant women, obese patients, patients with antiphospholipid syndrome and the incidence of cancer represent a great therapeutic challenge in the application of anticoagulant therapy. In these patients, not only must the effectiveness of the drugs be taken into account, but great attention must be paid to their safety and possible side effects, which is why a multidisciplinary approach is emphasized in order to provide the best therapeutic option.

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McConnell Sign in a Patient with Massive Acute Pulmonary Embolism

Cited by 2 publications

References 6 publications

McConnell's sign: Echocardiography in the management of acute pulmonary embolism

McConnell's sign: Echocardiography in the management of acute pulmonary embolism

Dilemmas in the Choice of Adequate Therapeutic Treatment in Patients with Acute Pulmonary Embolism—From Modern Recommendations to Clinical Application

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