{
  "abstract": "Introduction Right ventricular (RV) dysfunction is a key determinant of prognosis in acute pulmonary embolism (PE). European Society of Cardiology (ESC) guidelines recommend targeted use of imaging, including transthoracic echocardiography, for risk stratification with documentation of key RV parameters. Real-world imaging utilisation and reporting quality in acute PE remain variable. This audit evaluated imaging practice and right ventricular assessment in patients discharged with acute PE.Methods A retrospective audit was conducted at a UK district general hospital reviewing 50 adult patients discharged with a final diagnosis of acute pulmonary embolism between April and October 2020. Imaging utilisation was assessed across the diagnostic and post-diagnostic pathway. Indications for echocardiography were defined by documented clinical risk factors, including elevated Pulmonary Embolism Severity Index (PESI), raised B-type natriuretic peptide (BNP), right ventricular strain on CT pulmonary angiography (CTPA), or haemodynamic concern. Echocardiography reports were reviewed for documentation of RV parameters including tricuspid annular plane systolic excursion (TAPSE), tricuspid regurgitation (TR) pressure gradient, inferior vena cava (IVC) dimensions, and RV size.Results Transthoracic echocardiography was performed in 33 of 50 patients (66%). Based on documented clinical information, echocardiography was clearly indicated in 18 patients (36%), of whom 17 (94%) underwent imaging. Conversely, 16 echocardiograms (48% of those performed) were undertaken in patients without a clearly documented indication. Documentation of RV parameters was inconsistent: TAPSE was reported in 17 of 33 studies (52%), TR pressure gradient in 20 (61%), IVC dimensions in 9 (27%), and RV size in 26 (79%). At least one abnormal RV parameter was identified in 14 patients (42%).Conclusions Echocardiography is frequently utilised in acute pulmonary embolism, often beyond clearly documented indications, with substantial variability in right ventricular parameter reporting. Incomplete and inconsistent documentation may limit the effectiveness of imaging-based risk stratification. Standardised echocardiography reporting focused on RV assessment represents a pragmatic imaging-led intervention to improve guideline adherence and clinical decision-making. A re-audit is planned following implementation of targeted reporting standardisation.",
  "authors": [
    {
      "affiliations": [
        "Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom"
      ],
      "name": "Mohammad Abuzenah"
    },
    {
      "affiliations": [
        "Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom"
      ],
      "name": "Qossay Alsaafin"
    },
    {
      "affiliations": [
        "Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom"
      ],
      "name": "Helen Titu"
    },
    {
      "affiliations": [
        "Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom"
      ],
      "name": "Cerrie Haslam"
    },
    {
      "affiliations": [
        "Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom"
      ],
      "name": "Jawahar Lal"
    }
  ],
  "title": "320 Trip-right: imaging practice and right ventricular assessment in acute pulmonary embolism at a UK district general hospital",
  "uid": "53d5fa8d-9323-57e6-9a65-40a32a8f74b6"
}