Echocardiographic Assessment:

Performed within 24h of PE diagnosis Conventional parameters: TAPSE, RV FAC, RV/LV ratio, tricuspid S', PASP STE parameters: RV free wall longitudinal strain (RVFWS), global longitudinal strain (GLS) if feasible All measurements averaged over 3 cardiac cycles (sinus) or 5 (AF)

Follow-up data:

ICU/hospital LOS Need for vasopressors/mechanical ventilation In-hospital and 30-day mortality

the study targets patient with acute pulmonary embolism confirmed by CTPA, without hemodynamic instability. within the first 24 hours echocardiography will be conducted, assessment of RV function by conventional measures eg, TAPSE, S', FCA and speckle tracking strain echocardiography.

compare the results and its sensitivity in prediction of clinical outcomes, that will be assessed by follow up the patients for one month regarding length of hospital stay, oxygen/ventilatory support, hemodynamics support and 30 day mortality.

Inclusion Criteria:

1. Adults ≥18 years.
2. Confirmed acute PE (via CT pulmonary angiography).(4,6)
3. Echocardiography performed within 24 hours of diagnosis.

Exclusion Criteria:

1. Pre-existing significant RV dysfunction (e.g., due to chronic pulmonary hypertension, cor pulmonale or congenital heart disease).
2. History of coronary artery disease.
3. Impaired LV systolic function, ejection fraction <50%.
4. Moderate to severe valvular heart disease.
5. Prior document of an episode of pulmonary embolism.
6. Poor acoustic window.
7. Hemodynamic instability

patients aged more than 18 years old with confirmed pulmonary embolism