Key result
Prednisone and colchicine resolve RV dysfunction and McConnell's sign in an SLE myopericarditis case.
Why the study?
Despite high specificity for pulmonary embolism, other causes of McConnell's sign have been reported, motivating the description of a rare presentation associated with myopericarditis.
Case Report (n=1)
No
McConnell's sign can be present in inflammatory myopericardial syndromes, challenging its conventional diagnostic specificity for pulmonary embolism.
McConnell's sign resolved with anti-inflammatory therapy in myopericarditis; leaves open its specificity for pulmonary embolism.
McConnell’s sign is a classic echocardiographic finding most often encountered in the context of acute pulmonary embolism and is defined by severe hypokinesis or akinesis of the right ventricular free wall and hypercontractility of the apex. Despite having a high specificity for pulmonary embolism, other causes of McConnell’s sign have been reported. This case is a rare presentation of McConnell's sign in association with myopericarditis. The patient presented with a systemic lupus erythematosus flare as well as acute pleuritic chest pain and was found to have significantly elevated high-sensitivity troponin, pericardial effusion, and McConnell’s sign on echocardiography. Pulmonary embolism and underlying pulmonary hypertension were ruled out. The patient improved clinically with treatment of a systemic lupus erythematosus flare, and short-term follow-up echocardiography demonstrated resolution of right ventricular dysfunction. This case challenges the conventional diagnostic specificity attributed to McConnell’s sign for pulmonary embolism by describing a similar pattern of regional right ventricular wall motion abnormalities in the setting of an inflammatory myopericardial syndrome. Additionally, it underscores the utility of speckle-tracking strain analysis to help differentiate potential etiologies in right ventricular dysfunction. This case demonstrates the importance of having a broad differential when encountering McConnell’s sign and represents an underappreciated cause of McConnell’s sign associated with myopericarditis.
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Rector et al. (2026) conducted a case report in Myopericarditis (n=1). Prednisone and colchicine was evaluated on Resolution of right ventricular dysfunction and McConnell's sign. Anti-inflammatory therapy with prednisone and colchicine resolved right ventricular dysfunction and McConnell's sign in a 37-year-old female presenting with myopericarditis and an SLE flare.
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