{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:13:35Z","timestamp":1753877615969,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Introduction: Pulmonary embolism (PE) is a life-threatening condition characterized by occlusive disease of the pulmonary vasculature. Point-of-care ultrasound (POCUS) of right ventricular strain patterns have high specificity and low sensitivity for diagnosis. Here, we describe a patient with a saddle PE and low pre-test probability who was diagnosed primarily by handheld POCUS.<\/jats:p>\n               <jats:p>Case Report: An 80-year old female was admitted to the intensive care unit with hypotension and lactic acidosis. She also had mild leukocytosis and troponinemia. No other clinical or metabolic abnormalities were present. After transfer to the floor, handheld POCUS demonstrated D-sign and McConnell\u2019s sign. Computed tomography angiography showed a saddle PE involving both main pulmonary arteries. The patient was immediately initiated on anticoagulation without further complications.<\/jats:p>\n               <jats:p>Conclusion: Handheld POCUS is inexpensive, carries a low risk of harm and is an invaluable extension of the physical exam when interpreted in the appropriate context.<\/jats:p>","DOI":"10.1093\/omcr\/omab011","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T22:52:03Z","timestamp":1619650323000},"source":"Crossref","is-referenced-by-count":1,"title":["A near miss: subclinical saddle pulmonary embolism diagnosed by handheld ultrasound"],"prefix":"10.1093","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5577-0307","authenticated-orcid":false,"given":"Travis M","family":"Skipina","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S Allan","family":"Petty","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher T","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"key":"2021070812423236500_ref1","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1016\/S0140-6736(11)61904-1","article-title":"Pulmonary embolism and deep vein thrombosis","volume":"379","author":"Goldhaber","year":"2012","journal-title":"Lancet"},{"key":"2021070812423236500_ref2","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1016\/j.echo.2017.03.004","article-title":"Transthoracic echocardiography for diagnosing pulmonary embolism: a systematic review and meta-analysis","volume":"30","author":"Fields","year":"2017","journal-title":"J Am Soc 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(Kaunas)"},{"key":"2021070812423236500_ref6","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1080\/0142159X.2018.1457210","article-title":"Entrusting internal medicine residents to use point of care ultrasound: towards improved assessment and supervision","volume":"40","author":"Schnobrich","year":"2018","journal-title":"Med Teach"},{"key":"2021070812423236500_ref7","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1111\/aas.13083","article-title":"Simulation-based point-of-care ultrasound training: a matter of competency rather than volume","volume":"62","author":"Jensen","year":"2018","journal-title":"Acta Anaesthesiol Scand"},{"key":"2021070812423236500_ref8","doi-asserted-by":"crossref","first-page":"e0242731","DOI":"10.1371\/journal.pone.0242731","article-title":"Impact of virtual reality anatomy training on ultrasound competency development: a randomized controlled trial","volume":"15","author":"Hu","year":"2020","journal-title":"PLoS One"},{"key":"2021070812423236500_ref9","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1093\/ehjci\/jey145","article-title":"The use of handheld ultrasound devices: a position statement of the European Association of Cardiovascular Imaging (2018 update)","volume":"20","author":"Cardim","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2021070812423236500_ref10","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1540-8175.2010.01310.x","article-title":"Accuracy of handheld echocardiography for bedside diagnostic evaluation in a tertiary cardiology center: comparison with standard echocardiography","volume":"28","author":"Giusca","year":"2011","journal-title":"Echocardiography"}],"container-title":["Oxford Medical Case 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