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Use of bedside echocardiography for the diagnosis of pulmonary embolism in the emergency department

Report by: Janos Peter Baombe, Speciality Emergency Trainee

Checked by: Dan Horner, Specialist Registrar

Institution: Manchester Royal Infirmary, Manchester, UK

Three-part question

(In a previously fit and well patient presenting with clinical suspicion of pulmonary embolism) is (bedside transthoracic echocardiography compared to pulmonary angiography) specific and sensitive enough as a diagnostic test (to confirm or refute submassive/massive pulmonary embolism (PE))?

Clinical scenario

A 33 year-old male is brought into the emergency department with an episode of acute breathlessness following a syncopal episode. His left leg is in a cast and he tells us that he returned from Australia recently where he broke his lower limb during a trek. He is tachycardic, tachypnoic, hypotensive, sweaty and clammy: he is in a peri-arrest situation. You wonder if bedside transthoracic echocardiography could rapidly confirm or exclude your presumed diagnosis and support …

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