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.