Which imaging feature may indicate increased pulmonary pressures in a patient with a pulmonary embolism?

Increased pulmonary pressures, as seen in conditions like pulmonary embolism, often result in specific changes in the heart's structure and function. Mid-systolic notching of the right ventricular outflow tract (RVOT) is significant because it can reflect alterations in the heart's dynamics due to pressure overload on the right ventricle. When pulmonary pressures rise, the right ventricle has to work harder to pump blood into the pulmonary artery. This challenge can lead to changes in the flow profile observed on Doppler imaging, where mid-systolic notching becomes evident.

This feature is a direct manifestation of hemodynamic strain and is indicative of compromised right ventricular function under increased demand. It is a critical marker that can assist healthcare providers in assessing the severity of pulmonary hypertension, particularly in cases associated with pulmonary embolism, where rapid diagnosis and intervention can significantly impact patient outcomes.

Other features not directly linked to pulmonary pressures may reflect different pathologies. For instance, stenosis of the aortic valve pertains to left ventricular dynamics rather than the right, and right ventricular dilation, while indicative of pressure overload, does not provide the same immediate insight into the filling or outflow dynamics during the systolic phase as mid-systolic notching does