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The remaining PE categories are stratified into submassive, when there are signs of RV strain on echo, versus low-risk (also labeled small or minor), when there is no RV strain.35 EP FOCUS can help stratify these patients, with RV hypokinesis being an independent predictor of mortality.36 The presence of RV strain in suspected massive PE or diagnosed submassive PE may signal the need for more aggressive therapy such as thrombolysis or thrombectomy.35, 3739 Techniques for Assessing Equality When the A4C view is properly obtained, with all four chambers visible and divided by a vertically oriented interventricular septum, ventricular size can be accurately compared either qualitatively or quantitatively (Figure 5)

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