DIAGNOSTIC-ACCURACY OF ECHOCARDIOGRAPHY-DOPPLER IN ACUTE PULMONARY-EMBOLISM

We studied prospective recording of clinical, electrocardiographic, Do ppler and echographic parameters in 32 patients with proven pulmonary embolism, matched with 32 patients with clinically suspected pulmonary embolism and normal perfusion scan or angiography. Thirty-seven per c ent of cases and 16% of control subjects had clinical signs of right v entricular overload; S1-Q3-T3 ECG pattern was found in 11 cases and on e control. Other clinical and ECG parameters did not reach significant difference. Echographic septum motion was abnormal in 42% of cases an d 9% of controls (P < 0.05), end-diastolic right ventricular diameter was >25 mm in 67% of cases and 11% of controls, ratio of end-diastolic right over left ventricular diameters increased over 0.6 in 67% of ca ses and 11% of controls, while Doppler examination found tricuspid reg urgitant peak flow velocity >2.5 m/s in 84% of cases vs. 10% of contro ls. According to these parameters, Doppler-echocardiography was normal in 6% of cases and 87% of control subjects (P < 0.001 for each). In s uspected pulmonary embolism, our study shows that Doppler-echocardiogr aphy may be both sensitive and specific in emergency conditions and he lp the decision making for further invasive investigations.