PMC5884296_01
Transthoracic echocardiogram obtained before administration of t-PA: apical views showing a severely dilated right ventricle (RV) with reduced right ventricular systolic function. RV free wall is hypokinetic and RV apical wall is hypercontractile (arrow; McConnell sign). Left ventricular size and systolic function are normal.
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fig1
These findings were suggestive of a massive PE (Figure 1 and videos 1, 2).
Transthoracic echocardiogram 24 hours after t-PA administration: showing improvement in RV size (arrow) and function but still dilated.
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fig2
These findings were suggestive of a massive PE (Figure 1 and videos 1, 2). Repeat echocardiogram the next day showed improvement in RV size and function (Figure 2 and video 3).
CT angiogram showing pulmonary embolism (arrow).
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fig3
Repeat echocardiogram the next day showed improvement in RV size and function (Figure 2 and video 3).