What is the evidence that right ventricular dilatation on bedside echocardiography aids in the diagnosis of pulmonary embolism (PE)?

Updated: Jun 06, 2019
  • Author: Daniel R Ouellette, MD, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

A prospective observational study of 146 patients with suspected or confirmed pulmonary embolism indicates that identification of right ventricular dilatation on bedside echocardiography may aid diagnosis of pulmonary embolism. [79, 80] Bedside echocardiography showed right ventricular dilatation in 15 of the 30 patients who had pulmonary emboli, compared with 2 of the 116 patients without pulmonary emboli.

The presence of right ventricular dilatation on bedside echocardiography had a sensitivity of 50%, specificity of 98%, and positive and negative predictive values of 88% for the diagnosis of pulmonary embolism. [79, 80] Most of the 15 patients with confirmed pulmonary emboli and right ventricular dilatation had proximal clots, while most of those with confirmed pulmonary emboli and a normal right ventricular/left ventricular ratio had more distal clots. [79, 80]


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