Utilization of POCUS in Acute Pulmonary Embolism with Hemodynamic Instability: A Case Presentation

Authors

  • Marisa O'Brien Faculty of Medicine, Department of Emergency Medicine, Memorial University, St. John’s, NL, Canada
  • Eric Smith Faculty of Medicine, Department of Emergency Medicine, Memorial University, St. John’s, NL, Canada

Abstract

Introduction: A pulmonary embolism (PE) is a life-threatening condition requiring rapid identification and treatment. However, the non-specific symptoms associated with the acute onset of a PE make clinical diagnosis difficult. Point of care ultrasound (POCUS) is a readily available and evolving technique that allows for rapid identification of a PE. 

Case Presentation: 57-year-old patient presented to the Emergency Department (ED) hemodynamically unstable following an acute onset of shortness of breath and syncope. Ultrasonography revealed right ventricle (RV) dysfunction, abnormal tricuspid annular plane systolic excursion (TAPSE), and intravascular thrombosis, indicating a PE. Subsequently, the computed tomography pulmonary angiogram (CTPA) showed large bilateral pulmonary emboli and the patient received tissue plasminogen activator (TPA).

Discussion: The dependence of EDs on CTPA to rule in a PE before initiating thrombolytics may delay life-saving treatment. This case demonstrates the valuable addition of POCUS to the diagnostic protocol for PEs and reduces the waiting period in hemodynamically unstable patients to initiate empiric reperfusion therapy.

Conclusion: This case report demonstrates the benefits of POCUS in clinical decision making and highlights the advantages of its utility in the ED.

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Published

2025-01-17

How to Cite

O’Brien, M., & Smith, E. (2025). Utilization of POCUS in Acute Pulmonary Embolism with Hemodynamic Instability: A Case Presentation. Lithos - The Memorial University Medical Journal, 2(2), 18–22. Retrieved from https://journals.library.mun.ca/index.php/MUNMJ/article/view/2850

Issue

Vol. 2 No. 2 (2024): Vol. 2 No. 2 (2024)

Section

Case Report

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