Echocardiographic detection of reversible right ventricular strain in patients with acute pulmonary embolism: Report of 2 cases

This report presents serial echocardiographic changes recorded before and after anticoagulant therapy was administered to 2 patients with acute pulmonary embolism. Dilatation of the right ventricle, abnormal motion of the interventricular septum and mild tricuspid regurgitation were noted in both patients. The results of the echocardiogram suggested that the patients had right ventricular pressure overload resulting from pulmonary hypertension caused by an acute pulmonary embolism. Echocardiograms performed after the patients had received anticoagulant therapy revealed a normalization of the echocardiographic parameters in both patients. The reversal of the right ventricular strain pattern revealed by an echocardiogram occurred as the result of the regression of pulmonary hypertension after anticoagulant therapy. In conclusion, echocardiographic detection of right ventricular strain in patients who present acute cardiopulmonary manifestations with no previous history of severe pulmonary disease may indicate the possibility of a pulmonary embolism.