Chukwulebe S, Macias M - 2016, February 23 - NUEM Blog
Expert Peer Review by Courtney DM
Take Home Points
- CT scan suggesting any evidence of right heart strain identifies patients with moderate to high risk submassive PE
- Right heart strain on CT is associated both with RV dilation on echocardiogram and elevations in troponin and BNP biomarkers.
- The presence of right heart strain on CT has been variably associated with short term PE related death.
- Caveats: No studies have shown that any one finding on CT can predict mortality. And moreover, with the exception of the RV/LV diameter ratio, different radiologists may disagree about the presence or absence of the other markers for right heart strain far too frequently.
In light of this evidence, further studies may be needed to determine the clinical significance of these findings in the acute setting of the emergency department.