Use of Point-of-Care Ultrasound and Focus-Assessed Transthoracic Echocardiography to Diagnose Acute Right Heart Failure Due to Fat Emboli in a Parturient

Authors

Stephanie O Ibekwe
Varun Potluri
Raja Palvadi
Gavin T Best

Publication Date

8-1-2022

Journal

Cureus

DOI

10.7759/cureus.28585

PMID

36185894

PMCID

PMC9521511

PubMedCentral® Posted Date

8-30-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

multidisciplinary care, fate, point of care ultrasound, fat embolism syndrome, pulmonary hypertension, fat embolism, right heart failure

Abstract

Fat embolism syndrome (FES), causing right heart dysfunction, is a rare disease that is often difficult to diagnose with imaging modalities such as computed tomography (CT). FES is the clinical presentation that follows the entry of fat globules into the systemic circulation, which typically results in respiratory failure, scattered petechiae, cardiovascular collapse, and neurological sequelae. It is mostly observed in the cases of orthopedic trauma but may occur in any circumstance where fat can enter the circulatory system. In this case report, the authors describe an atypical presentation of FES in a 24-week parturient. The use of bedside point-of-care ultrasonography (POCUS) and the focus-assessed transthoracic echocardiography (FATE) protocol aided in the prompt diagnosis of right heart failure and helped to confirm the diagnosis of FES with more advanced imaging technology.