03 November 2025
: Case report 
Right Ventricular Volume Overload Mimicking Pulmonary Embolism: A Case of Intraoperative Fluid Absorption-Induced Ventricular Interdependence
Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Educational Purpose (only if useful for a systematic review or synthesis)
Chunliang Wang
BCDE 1, Yuzhu Fan AEF 2*, Juan Wang BCF 1, Yu Chen BCD 3, Ying Cui BCD 4, Hongzhao Zhang BCD 5
DOI: 10.12659/AJCR.950003
Am J Case Rep 2025; 26:e950003
Figure 1 Changes in echocardiographic parameters between postoperative and pre-discharge periods. (A) Postoperative four-chamber view demonstrates right ventricular dilation with flattened interventricular septum (blue arrow), McConnell’s sign (yellow arrow), RV/LV area ratio >1; (B) Pre-discharge four-chamber view shows normalized ventricular configuration; (C) Postoperative tricuspid valve flow spectrum reveals severe regurgitation (red arrow) with calculated systolic pulmonary artery pressure of 58 mmHg; (D) Pre-discharge tricuspid valve flow spectrum displays mild regurgitation with calculated systolic pulmonary artery pressure of 12 mmHg; (E) Postoperative pulmonary artery flow spectrum exhibits acceleration time <60 ms (60/60 sign) with mid-systolic notching (green arrow); (F) Pre-discharge pulmonary artery flow spectrum appears normal; (G) Postoperative mitral valve flow spectrum shows fused and elevated E/A waves (purple arrow); (H) Pre-discharge mitral valve flow spectrum demonstrates improved separation of E/A waves.