Echocardiographic Evaluation of Pulmonary Embolism and Its Response to Therapeutic Interventions

¹ The Harvard Medical School, Harvard Community Health Plan, and Brigham and Women's Hospital, Boston.

Since abnormalities of right ventricular size, septal position, right ventricular function, and tricuspid regurgitant flow velocity are seen in most patients with acute pulmonary embolism, echocardiography may prompt initial suspicion of pulmonary embolism and may serve to identify patients with hemodynamic compromise prior to the onset of cardiogenic shock. Controlled trials, such as that currently being undertaken by Goldhaber and colleagues, are being designed to determine whether echocardiographic abnormalities compatible with right ventricular dysfunction resolve more rapidly with thrombolytic therapy followed by intravenous heparin than with intravenous heparin alone.