McConnellâs Sign
- Akinesis of RV free wall
- Preservation (or even hyperdynamic appearance) of RV apex
- Although often taught in the context of acute PE, it is a non-specific finding as it can also be seen with other conditions. Examples in the Mayo Board Review course included ARDS, Sepsis, Pulmonary Hemorrhage, and COPD/respiratory failure.
- Presence more likely suggests acute process and is suggestive moreso of acute Right Heart Failure
- If you do strain studies, the RV apex is not actually normal. Rather, the RV apex is often akinetic. The preserved/hyperdynamic appearance of the RV apex is instead likely due to a tethering effect of hyperdynamic LV apex. 1
- Shown in đ by ALC
Footnotes
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LĂłpezâCandales, A., Edelman, K., & Candales, M. D. (2010). Right Ventricular Apical Contractility in Acute Pulmonary Embolism: The McConnell Sign Revisited. Echocardiography, 27(6), 614â620. Portico. https://doi.org/10.1111/j.1540-8175.2009.01103.x â©