[Role of MB-mode transthoracic echography in the early diagnosis of acute pulmonary embolism]

Abstract The aim of the present study was to evaluate whether transthoracic ecocardiography M-B mode was a sensitive and/or specific test for the early diagnosis of acute pulmonary embolism (PEA). For this purpose, we studied 7 patients with PEA as a complication of: deep leg venous thrombosis (3 cases), complicated bone fractures (2 cases), meniscectomy (1 case) and postpartum (1 case). The patients (3 males and 4 females), mean age of 46 +/- 7 years, did not have any previous earlier heart and/or pulmonary diseases. The diagnosis of PEA was made on the basis of clinical criteria, ecg and laboratory tests. Ecocardiography was performed using an IREX 3 M-B mode equipment; the measurements for the calculation of the indexes were made utilizing a short axis parasternal window. The parameters studied were: RVEDD/LVEDD ratio, LVDI Okubo index and the TR grade. Data were analyzed employing the paired Student's t test. In all patients was observed a statistically significant enlargement on the right heart cavities; while only in 3 of them was it possible to observe a slight reduction of the left ventricular cavities. In conclusion, the ecocardiographic exam was is a sensitive test for the diagnosis of PEA. Particularly, the RVEDD/LVEDD ratio gave an early and quantitative indication of the obstruction severity. Indeed, the morphological alteration of the right cavities became evident when the embolic obstruction was of at least 30%. Hence, we suggest that the standard ecocardiography M-B. mode may be regarded has a rapid diagnostic tool for the diagnosis of PEA.