Quantification of right ventricular function in acute pulmonary embolism: relation to extent of pulmonary perfusion defects

Abstract

Mid ventricular longitudinal dysfunction consistent with the 'McConnell-sign' is found in patients with moderate degrees of perfusion defects, whereas the acceleration time of the PA flow is reduced even in patients with small pulmonary emboli.

Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism – correlation with D-dimer level, right heart strain and clinical outcome

“…In contradiction to Kjaergard et al [33], who reported a correlation between right heart strain and a minimum of 25% loss of lung perfusion on perfusion scintigraphy, we assessed RHS at an average loss of 215.4 ml VolPD and 9.9% RelPD , thus indicating that even relatively small reductions of pulmonary blood volume may lead to RHS and put the patient at risk.…”

Evaluation of right ventricular dysfunction and prediction of clinical outcomes in acute pulmonary embolism by chest computed tomography: comparisons with echocardiography

“…Although echocardiographic criteria for RV dysfunction differ among studies [5,18,19], we evaluated RV hypokinesia as an index of RV dysfunction in accordance with the ICOPER [1].…”

McConnell Sign in a Patient with Massive Acute Pulmonary Embolism

“…Attempts to relate extent of pulmonary perfusion defects with regional right ventricular dysfunction has shown that at least 25% (moderate degree) of pulmonary perfusion defect is required for the McConnell sign to be demonstrated by transthoracic echocardiogram. Smaller perfusion defects have been noted to decrease acceleration time of the PA flow which could be a more sensitive parameter for assessment of right ventricle pressure overload in cases of small acute pulmonary embolism [5]. As noted above, our patient had massive bilateral pulmonary embolism which led to severe right ventricular mid-free wall dysfunction due to sudden increase in right ventricle pressure.…”