J Emerg Med
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We investigated the diagnostic utility of transthoracic echocardiogram (2-D ECHO) in identifying acute right heart strain in patients with suspected pulmonary embolus (PE) undergoing a pulmonary angiogram during their hospitalization. A retrospective case control study was conducted over a 3-year period at a tertiary, community teaching hospital. Patients were eligible if they had a pulmonary angiogram and a transthoracic echocardiogram. ⋯ The echocardiogram was positive in 14 patients, for a positive predictive value of 0.93. In seven patients with systolic blood pressures of less than 100 mmHg, five had a PE, all of whom met our criteria for acute right heart strain. We conclude that 2-D ECHOs show promise in identifying PE and hemodynamic compromise as a result of PE, and that further studies are warranted.