Ultrasound Case 012
Presentation
54 year old male presenting with collapse while moving couch. The patient is on antibiotics for recent pneumonia diagnosis. Altered mental status in the emergency department.
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Describe and interpret these scans
IMAGE INTERPRETATION
Image 1: Parasternal long axis of the heart with a large right heart and septum bowing into the left ventricle.
Image 2: Parasternal short axis of the heart, again showing a large right heart and a “D” shaped septum consistent with right heart strain.
Image 3: Longitudinal view of the IVC shows a plethoric IVC with spontaneous echo contrast.
Image 4: Femoral veins were compressed proximally and collapsed, showing no proximal femoral venous DVT.
Image 5: After the patient arrested, tPA 50 mg IV bolus was given, ROSC was achieved and the right heart strain is showing improvement.
CLINICAL CORRELATION
Massive pulmonary embolism and cardiac arrest.
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