Síguenos en Twitter     Síguenos en Facebook     Síguenos en Google+     Síguenos en YouTube     Siguenos en Linkedin     Correo Grupsagessa     Gmail     Yahoo Mail     Dropbox     Instagram     Pinterest     Slack     Google Drive     Reddit     StumbleUpon     Print

SOBRE EL AUTOR **

Mi foto
FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

500

Buscar en contenido

Contenido:

lunes, 8 de febrero de 2016

TTE for RV Strain

emDocs – February 8, 2016 - By Manpreet Singh
Originally published at R.E.B.E.L. EM on April 7, 2015. By  Cirilli A.
"Abnormal vital signs are poor predictors of mortality associated with pulmonary embolism (PE). Diagnosis of PE and right ventricular (RV) strain with transthoracic echocardiography (TTE) however, has been well documented as a predictor for pending shock and significant in-hospital mortality. One study done by Grifoni S et al, showed that 10% of normotensive patients with PE and RV strain on echo developed PE related shock, and 3% died, whereas normotensive patients without signs of RV strain remained hemodynamically stable. 
TAKE HOME POINTS
  • Point of Care echo is very good for the detection of RV strain
  • In the setting of suspected PE, RV strain on echo is not sensitive for the prediction of PE but it is more specific.
  • In the setting of hemodynamic instability the detection of RV strain seems to be very specific for PE
  • The finding of a right heart thrombus in the setting of PE and RV strain doubles the mortality up to 29%
  • Echo identified right heart thrombus most likely requires more aggressive treatment such as embolectomy or lytic therapy compared to heparin alone, however this requires further investigation"