Key result
Bedside sonography in a young woman with massive pulmonary embolism revealed unusual signs including spontaneous blood echogenicity in the inferior vena cava and flat Doppler waveform.
Case Report (n=1)
This case highlights that massive pulmonary embolism can present without major right ventricular dilation, and alternative sonographic signs like IVC 'sludge' and flat lower limb Doppler waveforms can aid diagnosis.
May aid bedside PE diagnosis without major RV dilation; case report leaves validation and generalizability open.
Bedside focused echocardiography diagnosis of massive pulmonary embolism during cardiac arrest is mainly based on the detection of a dilated right ventricle, while the lack of compressibility of a deep vein of the lower limbs confirms diagnosis in doubtful cases. We describe a case of unusual sonographic signs in a young woman with cardiac arrest due to massive pulmonary embolism showing spontaneous blood echogenicity in the inferior vena cava ("sludge sign") and nonmodulated ("flat") Doppler waveform in the left lower limb veins, suggesting isolated iliac vein thrombosis.
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Volpicelli et al. (2011) conducted a case report in Massive pulmonary embolism with cardiac arrest (n=1). Bedside focused echocardiography was evaluated on Detection of unusual sonographic signs. Bedside sonography in a young woman with massive pulmonary embolism revealed unusual signs including spontaneous blood echogenicity in the inferior vena cava and flat Doppler waveform.
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