EchoBridge Pearl #4: Understanding the Pathophysiology of McConnell's Sign
- Stephen Alerhand
- 6 days ago
- 1 min read
Originally described in 1996, McConnell's sign is an additional adjunct finding that can further raise suspicion for acute pulmonary embolism in the appropriate clinical setting.
It is characterized by diffuse hypokinesis of the right ventricular (RV) free wall with preserved contraction of the RV apex.
Several mechanisms have been proposed to explain this finding:
1) Mechanical tethering of the RV apex to the hyperdynamic left ventricle
2) Acute changes in RV geometry that preferentially affect the mid-RV free wall
3) Localized ischemia of the right coronary artery perfusing the acutely pressure-overloaded RV free wall (vs. the RV apex, which is also perfused by the left anterior descending artery).
Understanding the physiology behind McConnell's sign helps explain why it is more commonly associated with acute RV pressure overload than with chronic pulmonary hypertension.
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