Revisiting Mcconnell′s Sign: Right Ventricular Infarction in the Absence of Pulmonary Embolism

McConnell′s sign, defined as hypokinesis of the right ventricular (RV) midfree wall with preserved apical contractions, was initially considered to be highly specific for acute pulmonary embolism. However, evidence indicates that it may also appear in other conditions involving RV dysfunction. Here, we report a case of McConnell′s sign associated with RV myocardial infarction in the absence of pulmonary embolism. A 74‐year‐old female was successfully resuscitated following cardiac arrest. Echocardiography revealed a dilated RV with moderate tricuspid regurgitation and a regional wall motion pattern characteristic of McConnell′s sign. Contrast‐enhanced computed tomography excluded a pulmonary embolism. Coronary angiography revealed an occluded right coronary artery, which was identified as the culprit lesion, and a chronically occluded left anterior descending artery with collateral flow. Conservative management led to gradual clinical and echocardiographic improvement. This case underscores that McConnell′s sign is not pathognomonic for pulmonary embolism and should be interpreted cautiously.