Service de cardiologie, pôle Cœur-Poumon, CHU Jean-Minjoz, Boulevard Fleming, 25030 Besançon Cedex
Measuring pulmonary artery pressure is an essential diagnostic and prognostic step in the management of acute pulmonary embolism (PE). Doppler echocardiography makes it possible to evaluate right heart hemodynamics non-invasively, based on several parameters whose validity has long been established. There are three main methods for estimating pulmonary arterial pressure using Doppler echocardiography, based on analysis of tricuspid regurgitation flow, pulmonary regurgitation flow, and pulmonary ejection flow. Data concerning the value of tissue Doppler in the diagnosis of PE are scant, and further studies are required before its diagnostic value can be confirmed. Pressure should be measured using all the methods available in complement to each other, in order to maximise the reliability of the measurements. Under these conditions, and given the number of parameters available, Doppler echocardiography can usually provide a reliable evaluation of the hemodynamic modifications encountered in pulmonary embolism.