The contribution of echocardiography in the management of thrombo-embolic disease.
To evaluate the contribution of echocardiography on the management of acute pulmonary embolism (A.P.E.) a study was carried out on 84 patients. For each of them echocardiography was performed: (a) the M mode shows an increase in RVDD/LVDD quotient correlated with the gravity of the A.P.E.; (b) the two dimensional mode allows 9 times the discovery of a thrombus which could be: static and broad based 6 cases or mobile, large sized 3 cases. So echocardiography can be systematically and initially be proposed for any patient suspected of having A.P.E.; (c) the absence of increase in RVDD/LVDD ratio 0.33 exclude the possibility of a serious A.P.E. and it is possible to postpone the pulmonary angiogram. On the contrary the increase of the RVDD/LVDD ratio must lead to the angiographic exploration due to the seriousness of A.P.E.: (d) the discovery of a mobile, large sized thrombus with hight embolic potential makes the catheterism of the right cavities dangerous and lead to an emergency embolectomy because of the high risks of a new A.P.E.
CHU Timone-Cardiologie, Marseille, France.
J L
JL
Bouvier
M
M
Benichou
A
A
Elias
G
G
Le Corff
A
A
Serradimigni
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006346:Heart Septum / Q000473:pathology; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011655:Pulmonary Embolism / Q000473:pathology*; D011660:Pulmonary Heart Disease / Q000473:pathology*; D013927:Thrombosis / Q000473:pathology