McConnell's Sign Is Not Always Pulmonary Embolism: The Importance of Right Ventricular Ischemia

Nikita Rafie; David A Foley; Juan G Ripoll; Michelle L Booth-Kowalczyk; Arman Arghami; Alberto Pochettino; Hector I Michelena

doi:10.1016/j.jaccas.2022.05.007

McConnell's Sign Is Not Always Pulmonary Embolism: The Importance of Right Ventricular Ischemia

JACC Case Rep. 2022 Jul 6;4(13):802-807. doi: 10.1016/j.jaccas.2022.05.007.

Authors

Nikita Rafie¹, David A Foley², Juan G Ripoll³, Michelle L Booth-Kowalczyk², Arman Arghami⁴, Alberto Pochettino⁴, Hector I Michelena²

Affiliations

¹ Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
² Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
³ Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
⁴ Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Abstract

McConnell's sign is a well-established, specific echocardiographic sign for acute pulmonary embolism. Multiple theories have been proposed regarding the mechanism of McConnell's sign in the context of acute pulmonary embolism. Here, we present 2 patient cases in which McConnell's sign was seen with right ventricular ischemia without pulmonary embolism. (Level of Difficulty: Beginner.).

Keywords: CT, computed tomography; PE, pulmonary embolism; RCA, right coronary artery; TTE, transthoracic echocardiogram; cardiology; echocardiogram; ischemia; right ventricular ischemia.

Publication types

Case Reports