Submassive Pulmonary Embolism – a critical care ECHO skill?

Images and Text Genevieve Carbonatto If we consider that there are different levels of expertise in the acquisition of knowledge of echocardiography for the Critical Care Physician, the recognition of acute cor pulmonale which we see with  submassive pulmonary embolus has been described as a Level II skill, level I being the minimal level of Read more about Submassive Pulmonary Embolism – a critical care ECHO skill?[…]

Pulmonary Embolism – Could you review your patient please, his BP is dropping

Images and text Genevieve Carbonatto and Tina Cullen. A 72 year old man presents to the Emergency Department with shortness of breath (SOB). He is severely SOB on minimal effort and has been unable to get out of bed for 2 days. He gives a story of 6 months of increasing SOB. This is corroborated Read more about Pulmonary Embolism – Could you review your patient please, his BP is dropping[…]

Pulmonary Embolus

Images by James Dent  McConnell’s sign is akinesis of the basal and mid segments of the RV free wall but apical preservation / hyperkinesis.  It is sensitive but not specific for pulmonary embolus Parasternal long axis of the left ventricle, (PLAX) demonstrating that the right ventricular, (RV) anterior wall is not contracting well.  The RV Read more about Pulmonary Embolus[…]

Pulmonary embolus (PE)

Images by Genevieve Carbonatto  Subcostal view. Large right ventricle, small left ventricle, intraventricular septum flattened Subcostal 4-chamber view demonstrating severely dilated right heart with significantly reduced right ventricular contractility.  The interventricular septum is flattened more during diastole.  Small cavity left ventricle.  (RV is the “preload” of the LV). There is the appearance of a small amount Read more about Pulmonary embolus (PE)[…]