Case Reports
Vol. 7 No. 3 (2021)
https://doi.org/10.4081/gc.2021.10280
McConnel sign, a simple highly specific sign for identification of a frequent, under diagnosed association: pulmonary embolism and syncope
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 15 November 2021
Accepted: 31 January 2022
Published: 9 February 2022
Accepted: 31 January 2022
Published: 9 February 2022
2084
Views
304
Downloads
26
HTML
Syncope is a common reason for emergency room visits and hospital admission and, in about one patient out of six it can be a manifestation of pulmonary embolism (PE). The prognosis of this condition is largely dependent on the timing of diagnosis and treatment since early anticoagulation may modify the clinical consequences of PE and further loss of consciousness. In this article, we describe the case of a woman presenting with syncope, who showed at the admission a cardiac ultrasound highly specific cluster of signs of pulmonary embolism. This rapid non-invasive evaluation permitted to identify causal diagnosis and to speed up the clinical process.
Downloads
Download data is not yet available.
References
Goyal P, Maurer MS. Syncope in older adults. J Geriatr Cardiol 2016;13:380-6.
Kapoor WN. Evaluation and outcome of patients with syncope. Med (United States) 1990;69:160-75. DOI: https://doi.org/10.1097/00005792-199005000-00004
Sun BC, Emond JA, Camargo CA. Direct medical costs of syncope-related hospitalizations in the United States. Am J Cardiol 2005;95:668-71. DOI: https://doi.org/10.1016/j.amjcard.2004.11.013
Soteriades ES, Evans JC, Larson MG, et al. Incidence and prognosis of syncope. N Engl J Med 2002;347:878-85. DOI: https://doi.org/10.1056/NEJMoa012407
Alpert JS. Syncope in the elderly. Am J Med 2019;132:1115-6. DOI: https://doi.org/10.1016/j.amjmed.2019.05.001
Brignole M, Menozzi C, Bartoletti A, et al. A new management of syncope: prospective systematic guideline-based evaluation of patients referred urgently to general hospitals. Eur Heart J 2006;27:76-82. DOI: https://doi.org/10.1093/eurheartj/ehi647
Ungar A, Mussi C, Del Rosso A, et al. Diagnosis and characteristics of syncope in older patients referred to geriatric departments. J Am Geriatr Soc 2006;54:1531-6. DOI: https://doi.org/10.1111/j.1532-5415.2006.00891.x
Brignole M, Moya A, De Lange FJ, et al. 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J 2018;39:1883-948. DOI: https://doi.org/10.1093/eurheartj/ehy210
Kapoor W, Snustad D, Peterson J, et al. Syncope in the elderly. Am J Med 1986;80:419-28. DOI: https://doi.org/10.1016/0002-9343(86)90716-3
Solbiati M, Casazza G, Dipaola F, et al. Syncope recurrence and mortality: a systematic review. Europace 2015;17:300-8. DOI: https://doi.org/10.1093/europace/euu327
Bilora F, Sarolo L, Pomerri F, Prandoni P. Syncope in elderly people: a threatening presentation of pulmonary embolism: a case report. Archiv Med 2015;7:18.
Prandoni P, Lensing AWA, Prins MH, et al. Prevalence of pulmonary embolism among patients hospitalized for syncope. N Engl J Med 2016;375:1524-31. DOI: https://doi.org/10.1056/NEJMoa1602172
Konstantinides SV, Meyer G, Becattini C, ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 2020;41:543-603. DOI: https://doi.org/10.1093/eurheartj/ehz405
Patra S, Math RS, Shankarappa RK, Agrawal N. McConnell’s sign: An early and specific indicator of acute pulmonary embolism. BMJ Case Rep 2014;2014:bcr2013200799. DOI: https://doi.org/10.1136/bcr-2013-200799
McConnell MV, Solomon SD, Rayan ME, et al. Regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol 1996;78:469-73. DOI: https://doi.org/10.1016/S0002-9149(96)00339-6
Calvin JE. Pressure segment length analysis of right ventricular function: Influence of loading conditions. Am J Physiol Hear Circ Physiol 1991;260. DOI: https://doi.org/10.1152/ajpheart.1991.260.4.H1087
Janz RF, Kubert BR, Pate EF, Moriarty TF. Effect of shape on pressure-volume relationships of ellipsoidal shells. Am J Physiol Hear Circ Physiol 1980;7(6). DOI: https://doi.org/10.1152/ajpheart.1980.238.6.H917
Kurzyna M, Torbicki A, Pruszczyk P, et al. Disturbed right ventricular ejection pattern as a new Doppler echocardiographic sign of acute pulmonary embolism. Am J Cardiol 2002;90:507-11. DOI: https://doi.org/10.1016/S0002-9149(02)02523-7
Torbicki A, Galié N, Covezzoli A, et al. Right heart thrombi in pulmonary embolism: results from the International Cooperative Pulmonary Embolism Registry. J Am Coll Cardiol 2003;41:2245-51. DOI: https://doi.org/10.1016/S0735-1097(03)00479-0
Goldhaber SZ. Echocardiography in the management of pulmonary embolism. Ann Intern Med 2002;136:691-700. DOI: https://doi.org/10.7326/0003-4819-136-9-200205070-00012
Sosland RP, Gupta K. McConnell’s sign. Circulation 2008;118:e517-8. DOI: https://doi.org/10.1161/CIRCULATIONAHA.107.746602
How to Cite
McConnel sign, a simple highly specific sign for identification of a frequent, under diagnosed association: pulmonary embolism and syncope. (2022). Geriatric Care, 7(3). https://doi.org/10.4081/gc.2021.10280
Copyright (c) 2021 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.