title: Sonographic diagnosis of pulmonary embolism with cardiac arrest without major dilation of the right ventricle or direct sign of lower limb venous thrombosis.
abstract: Bedside focused echocardiography diagnosis of massive pulmonary embolism during cardiac arrest is mainly based on the detection of a dilated right ventricle, while the lack of compressibility of a deep vein of the lower limbs confirms diagnosis in doubtful cases. We describe a case of unusual sonographic signs in a young woman with cardiac arrest due to massive pulmonary embolism showing spontaneous blood echogenicity in the inferior vena cava ("sludge sign") and nonmodulated ("flat") Doppler waveform in the left lower limb veins, suggesting isolated iliac vein thrombosis.
authors.affiliation: Department of Emergency Medicine, San Luigi Gonzaga University Hospital, Torino, Italy. gio.volpicelli@tin.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Volpicelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mussa
authors.forename: Mauro F
authors.initials: MF
authors.lastname: Frascisco
mesh_terms: D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000628:therapy; D016638:Critical Illness; D004108:Dilatation, Pathologic; D018450:Disease Progression; D015150:Echocardiography, Doppler; D004636:Emergency Service, Hospital; D017809:Fatal Outcome; D005260:Female; D006323:Heart Arrest / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010690:Phlebography / Q000379:methods; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D018570:Risk Assessment; D018617:Ultrasonography, Doppler, Pulsed; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*; D055815:Young Adult