Patient sent up to the MICU with presumed distributive shock from sepsis
Always remember to perform a quick POCUS to make sure you& #39;re not missing something
1) IVC very plump with retrograde material without respiratory variation, hence not looking preload-depleted

Parasternal long axis: shows no large discernable effusion to suggest tamponade, EPSS performed in M Mode showed normal LVEF
But look at that Right ventricle!!

Parasternal short axis: shows definite septal flattening in diastole and both parasternal views showed an RV:LV ratio >0.9 @EM_RESUS @PulmCrit

Finally Apical 4 chamber view confirms all the previous findings suggestive of massive PE leading to significant RV pressure overload and hemodynamic compromise

The patient& #39;s UA showed signs of possible infection and started the narrative for septic shock but this underscores the usefulness of a simple bedside echo to help determine shock physiology and etiology
@JulioHuapayaMD @HFHPulmCC @DrBryanMSU #FOAMcc #FOAMed #CriticalCare