Chapter 4. Ischemic heart disease, TakoTsubo syndrome, ACS, pulmonary embolism, pulmonary edema

Chapter 4. Ischemic heart disease, TakoTsubo syndrome, ACS, pulmonary embolism, pulmonary edema

Pulmonary embolism & pulmonary hypertension

  • FWS worsening as a marker of bad prognosis in PE (-14,4% ±7,2%)

  • In pulmonary hypertension a FWS with -15% & a GS with -15,3% as cut-off for worse prognosis

  • RASr reduction in in acute PE

  • FWS — basal & mid reduction in PE compared to apical values (Strain“ McConnell Sign)


Pulmonary embolism

Central PE with RV-dilatation, normal FWS, GS & RASr & RASct

Central PE with RV-dilatation, normal FWS, GS & RASr & RASct

RA/RV thrombus & PE with severely reduced FWS & GS; atypical PLAX RV-inflow view with reduced RV anterior strain
(no normal values)

RA/RV thrombus & PE with severely reduced FWS & GS; atypical PLAX RV-inflow view with reduced RV anterior strain
(no normal values)

Pulmonary hypertension

Pulmonary hypertension in ILD with significantly reduced FWS & GS with massive RV-dilatation

Pulmonary hypertension in ILD with significantly reduced FWS & GS with massive RV-dilatation

Follow-up PE / CTEPH with "Strain" McConnell Sign

Follow-up PE / CTEPH with "Strain" McConnell Sign

Trivedi et.al., Int J Cardiovasc Imaging, 2020 / Hekimsoy et al., nt J Cardiovasc Imaging, 2018 / Altersberger, Genger et al., 2023 / Azzolini et al. 2021

Pulmonary edema

  • LASr with 16,2% as a predictor for pulmonary edema in heart failure patients

  • In pulmonary edema LASr decreased with 9,2%; vs 21,5% in HF without pulmonary edema

  • Worse LA Strain ➜ more pulmonary edema

  • LASr as a marker of LV-failure and LA-pressure rise until pulmonary edema as a life-threatening condition in heart failure

LUS

LUS

Li et al, Frontiers in CV Medicine, 2023

The contents of the website, including the videos, were created without influence from third parties.

The contents of the website, including the videos, were created without influence from third parties.

The Strain Book

Represented by Dr. Martin Altersberger

Contact: heart.lungs.ultrasound@gmail.com

The Strain Book

Represented by Dr. Martin Altersberger

Contact: heart.lungs.ultrasound@gmail.com

© 2026 The Strain Book by Dr. Martin Altersberger. All rights reserved.

© 2026 The Strain Book by Dr. Martin Altersberger. All rights reserved.

© 2026 The Strain Book by Dr. Martin Altersberger. All rights reserved.