Format

Send to

Choose Destination
See comment in PubMed Commons below
J Emerg Med. 2015 Sep;49(3):301-4. doi: 10.1016/j.jemermed.2014.12.089. Epub 2015 May 16.

McConnell's Sign Is Not Specific for Pulmonary Embolism: Case Report and Review of the Literature.

Author information

1
Department of Emergency Medicine, Bridgeport Hospital, Bridgeport, Connecticut.
2
Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut.

Abstract

BACKGROUND:

McConnell's sign (right ventricular [RV] free wall hypokinesis with apical sparing on echocardiography) is often described as very specific for the diagnosis of pulmonary embolism (PE). We present the case of a patient who, despite manifesting a classic McConnell's sign, was not found to have a PE.

CASE REPORT:

A 58-year-old woman presented to the emergency department with a cough, dyspnea, and leg swelling. A bedside focused cardiac ultrasound revealed hypokinesis of the RV free wall, with apical sparing, in the apical four-chamber view. A computed tomography angiogram for PE was negative. Ultrasounds of both lower extremities were negative for deep venous thrombosis, and a D-dimer was only marginally elevated. The patient was ultimately diagnosed with pulmonary hypertension due to chronic obstructive pulmonary disease and systemic lupus erythematosus. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be aware that McConnell's sign is not completely specific for acute right heart strain from PE.

KEYWORDS:

McConnell's sign; echocardiography; emergency department; focused cardiac ultrasonography; pulmonary embolism; pulmonary hypertension

PMID:
25986329
DOI:
10.1016/j.jemermed.2014.12.089
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center