Role of Echocardiography in a Patient With Suspected Acute Pulmonary Embolism

A Case Report

Julio Miranda-Bacallado; María Manuela Izquierdo-Gómez; Javier García-Niebla; Juan José Jiménez; José Luis Iribarren; Ignacio Laynez-Cerdeña; Juan Lacalzada-Almeida


J Med Case Reports. 2019;13(37) 

In This Article


Our patient's case highlights the fundamental role of echocardiography in critically ill patients for whom the poor-quality imaging of TTE is addressed by TEE. In our patient, TEE allowed us to exclude other alternative diagnoses that were contemplated a priori at the bedside of a critically ill patient with severe respiratory and hemodynamic instability. The robust echocardiographic findings in our patient caused us to suspect PE, avoiding an unnecessary transfer of the patient to perform other complementary diagnostic tests such as CT pulmonary angiography and allowing the immediate initiation of specific therapeutics, leading to an excellent clinical outcome. CT pulmonary angiography could be performed later with a more grounded suspicion to justify the initiation of specific therapy. The subsequent TEE examination allowed us to evaluate the effectiveness of medical therapy and possible morphofunctional sequelae on the right side of the heart in the early stage. Therefore, in a patient in the ICU in shock, echocardiography plays a fundamental role in the differential diagnosis of the causes of shock, and knowledge of the echocardiographic findings of PE can prevent the diagnosis from going unnoticed.