Copyright © 2005, The European Society of Cardiology
Regional right ventricular dysfunction in acute pulmonary embolism and right ventricular infarction
Division of Cardiology, San Carlo Borromeo Hospital, via Pio 2°, n 3, 20153 Milan, Italy
Received 14 April 2004; received in revised form 14 April 2004; accepted after revision 2 June 2004.
* Corresponding author. via Nikolajevka 12, 20152, Milan, Italy. Tel.: +39-2-4022-2943. fcasazza{at}tin.it
 |
Abstract |
|---|
Background: A normally contracting right ventricular apex associated to a severe hypokinesia of the mid-free wall (‘McConnell sign’) has been considered a distinct echocardiographic pattern of acute pulmonary embolism.
Objective: To evaluate the clinical utility of the ‘McConnell sign’ in the bedside diagnostic work-up of patients presenting to the Emergency Department with an acute right ventricular dysfunction due to pulmonary embolism or right ventricular infarction.
Design: Among 201 patients, consecutively selected from our clinical database and diagnosed as having massive or submassive pulmonary embolism or right ventricular infarction, 161 were suitable for an echocardiographic review of regional right ventricular contraction and were included in the study. There were 107 cases with pulmonary embolism (group 1) and 54 cases with right ventricular infarction (group 2). All echocardiographic studies were randomly examined by two experienced and independent echocardiographers, blinded to the patient diagnosis and without Doppler informations.
Results: The McConnell sign was detected in 75 of 107 patients in group 1 (70%) and in 36 of 54 patients in group 2 (67%); the finding was absent in 32 cases in group 1 and in 18 cases in group 2 (P=0.657). The sensitivity, specificity, positive and negative predictive values of the McConnell sign for the diagnosis of pulmonary embolism were respectively 70, 33, 67 and 36%.
Conclusions: In a clinical setting of patients with acute right ventricular dysfunction the McConnell sign cannot be considered a specific marker of pulmonary embolism.
Keywords: Echocardiography; Right ventricular wall motion; Pulmonary embolism; Right ventricular infarction
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in Eur J Echocardiogr:
- Echocardiographic diagnosis of pulmonary embolism: a rise and fall of McConnell sign?
- A. Torbicki
Eur J Echocardiogr 2005 6: 2-3.[Extract] [Full Text]
This article has been cited by other articles:
|
|
 |
|
  R. Jurcut, S. Giusca, A. La Gerche, S. Vasile, C. Ginghina, and J.-U. Voigt The echocardiographic assessment of the right ventricle: what to do in 2010? Eur J Echocardiogr, February 2, 2010; (2010): jep234v1 - jep234. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, A. Torbicki, A. Perrier, S. Konstantinides, G. Agnelli, N. Galie, P. Pruszczyk, F. Bengel, A. J.B. Brady, D. Ferreira, et al. Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) Eur. Heart J., September 2, 2008; 29(18): 2276 - 2315. [Full Text] [PDF]
|
|
|
|
 |
|
 S. R. Punnam and A. Dhoble Right ventricular asynergy as a prognosticator. J. Am. Coll. Cardiol., April 22, 2008; 51(16): 1616 - 1616. [Full Text] [PDF]
|
|
|
|
 |
|
 F. Haddad, S. A. Hunt, D. N. Rosenthal, and D. J. Murphy Right Ventricular Function in Cardiovascular Disease, Part I: Anatomy, Physiology, Aging, and Functional Assessment of the Right Ventricle Circulation, March 18, 2008; 117(11): 1436 - 1448. [Full Text] [PDF]
|
|
|
|
|
|
P. Lindqvist, A. Calcutteea, and M. Henein Echocardiography in the assessment of right heart function Eur J Echocardiogr, March 1, 2008; 9(2): 225 - 234. [Abstract] [Full Text] [PDF]
|
|