Multimodality Imaging Evaluation of Reverse McConnell's Sign and Right Ventricular Apical Thrombosis in Acute Pulmonary Embolism.

ABSTRACT: McConnell's sign, characterized by hypokinesia of the mid-free wall of the right ventricle (RV) with preserved apical contractility, is a well-recognized echocardiographic marker in acute pulmonary embolism (PE). However, its reverse variant-apical akinesia with preserved basal function-is rare and less understood. We report the case of an 85-year-old woman presenting with acute PE, who exhibited a rare form of RV dysfunction known as Reverse McConnell's sign. Multimodality imaging-including computed tomography (CT), transthoracic echocardiography, and cardiac magnetic resonance (CMR)-revealed apical RV akinesia and a concurrent intracavitary thrombus at the RV apex. Based on imaging, laboratory biomarkers, and clinical findings, an intermediate-high risk PE was diagnosed. The patient was

SUBMITTER: Malerba C 

PROVIDER: S-EPMC12697744 | biostudies-literature | 2025 Jul-Sep

REPOSITORIES: biostudies-literature