Role of transthoracic echocardiography in the diagnosis of acute pulmonary embolism

OBJECTIVES: The objective of our work is to determine the value of transthoracic echocardiography (TTE) in the diagnosis of pulmonary embolism (PE) and its place in the diagnostic strategy in a cardiology department in Tunisia. MATERIAL AND METHODS: It is a retrospective study including 43 patients between 1993 and 2003 in the cardiology department of the "Hopital Militaire Principal d'Instruction de Tunis" for acute pulmonary embolism. RESULTS: Our population had a feminine ascendancy. The average age was 53.9 +/- 17.6 years. In patients with positive pulmonary perfusion scintigram and by taking pulmonary helical CT as diagnostic gold standard, we found that TTE yielded a sensivity of 74 % and a specificity of 25 % for the diagnosis of pulmonary embolism. The most common echocardiographic signs were the right cavities dilation and the increase of right pressures. CONCLUSION: Transthoracic echocardiography is a good test to screen patients for suspected PE because it has an excellent sensitivity. It must be often completed by transesophageal echocardiography and integrated in all diagnostic approach of pulmonary embolism.