Role of Echocardiography in Evaluation of PE
Echocardiography is not a diagnostic method for
PE[5] but is used for patient risk
stratification[1, 7].
TTE provide noninvasive assessment of
RV and LV size, systolic function, regional wall motion, valvular
abnormalities, and hemodynamic assessment of filling pressure and
right-heart pressures.
However, echocardiography has some inherent limitations in the diagnosis
of APE. First, the ultrasound beam loses energy as travelling through
tissue; therefore the structures away from the chest wall may not be
well showed by TTE[8].
As a result, structures that may be
important sources of embolism, such as the posteriorly located left
atrium and its appendage, the interatrial septum, and the thoracic
aorta, may be suboptimally visualized by TTE. Besides, it should be
noted that signs of RV overload are not specific for PE and that acute
and chronic RV abnormalities may be due to concomitant cardiac or
respiratory disease[1, 9], such as chronic
obstructive pulmonary disease, obstructive sleep apnea, pulmonary
hypertension, right-heart failure, and right-sided myocardial
infarction, among others.