Sonographic diagnosis of pulmonary embolism with cardiac arrest without major dilation of the right ventricle or direct sign of lower limb venous thrombosis

Bedside focused echocardiography diagnosis of massive pulmonary embolism during cardiac arrest is mainly based on the detection of a dilated right ventricle, while the lack of compressibility of a deep vein of the lower limbs confirms diagnosis in doubtful cases. We describe a case of unusual sonogr...

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Bibliographic Details
Published in:Journal of clinical ultrasound 2012-10, Vol.40 (8), p.529-533
Main Authors: Volpicelli, Giovanni, Mussa, Alessandro, Frascisco, Mauro F.
Format: Article
Language:English
Subjects:
cardiac arrest
Cerebral Hemorrhage - diagnosis
Cerebral Hemorrhage - therapy
Critical Illness
deep venous thrombosis
Dilatation, Pathologic
Disease Progression
Echocardiography, Doppler
Emergency Service, Hospital
emergency ultrasound
Fatal Outcome
Female
Heart Arrest - complications
Heart Arrest - diagnosis
Heart Arrest - therapy
Heart Ventricles - diagnostic imaging
Humans
Iliac Vein - diagnostic imaging
Iliac Vein - physiopathology
Phlebography - methods
pulmonary embolism
Pulmonary Embolism - complications
Pulmonary Embolism - diagnostic imaging
Pulmonary Embolism - therapy
Risk Assessment
thromboembolism
Ultrasonography, Doppler, Pulsed
Venous Thrombosis - diagnostic imaging
Young Adult
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Description
Summary:Bedside focused echocardiography diagnosis of massive pulmonary embolism during cardiac arrest is mainly based on the detection of a dilated right ventricle, while the lack of compressibility of a deep vein of the lower limbs confirms diagnosis in doubtful cases. We describe a case of unusual sonographic signs in a young woman with cardiac arrest due to massive pulmonary embolism showing spontaneous blood echogenicity in the inferior vena cava (“sludge sign”) and nonmodulated (“flat”) Doppler waveform in the left lower limb veins, suggesting isolated iliac vein thrombosis. © 2011 Wiley Periodicals, Inc. J Clin Ultrasound 40:529–533, 2012
ISSN:0091-2751
1097-0096
DOI:10.1002/jcu.20860