打通PAOD tips

1.
做PAOD常用single-plane X-ray，如果找不到stump or entry point，
可將single-plane X-ray打到垂直90度嘗試找。

Pulmonary embolism

Case: 

CC: Chronic dyspnea for 2yrs

PE: Widely split S2、accentuated P2、borderline JVE

ECG: SR, tall R in V1, S1Q3T3

Echocardiogram: McConnell's Sign

( Akinesia of the mid-free wall but normal motion of the apex. A 77% sensitivity and a 94% specificity for the diagnosis of acute pulmonary embolism in the setting of right ventricular dysfunction)

Another echocardiographic finding of PE: 60/60 sign

(The “60/60” sign is defined 

as an acceleration time ≦ 60 milliseconds in the presence of a

tricuspid regurgitation pressure gradient of < 60 mmHg.

The sensitivity, specificity, PPV, and negative predictive value of the

60/60 sign in the diagnosis of acute PE was reported to be 25%,

94%, 90%, and 38% respectively.)

Typical PE finding of PE: widely split S2、accentuated P2、RV heave、parasternal S4、high JVP

Q: acute PE和chronic PE的差別?