ABSTRACT
Acute pulmonary embolism (PE) remains one of the major causes of in-hospital mortality. Its prompt and accurate diagnosis is especially important in hemodynamically unstable patients, because they may require urgent thrombolysis or surgery. The noninvasive character of echocardiography and its high bedside availability are particularly useful in an emergency setting, and increasingly appreciated in suspected acute PE. Recent large-scale registry showed that, in the most hemodynamically compromised patients with suspected acute PE, routine diagnostic procedures, such as angiography, lung scintigraphy, and spiral computed tomography (sCT), were performed less frequently, and the diagnosis of PE was mainly based on clinical evaluation and echocardiography.1 Moreover, in a retrospective study of 1246 cardiac arrest victims, echocardiography was the most commonly used imaging method, revealing the diagnosis in 24 out of 60 (40%) patients suffering from acute PE.2 This chapter provides information which should help to optimize the use of echocardiography in emergency assessment of patients with suspected or confirmed acute PE.
