Abstract Background Pulmonary embolism (PE) is the third most frequent cause of death in the world. In epidemiological studies, annual incidence rates for PE range from 39-115 per 100 000 population. Acute PE interferes with both circulation and gas exchange. Right ventricular (RV) failure due to acute pressure overload is considered the primary cause of death in severe PE. Case Summary A 70-year-old female patient presents to the emergency room of RSUDZA with complaints of typical chest pain that has been experienced since 3.5 hours before admission. In the emergency department, patients with obesity status with a general condition are weak and agitated. Physical examination found within normal limits. From laboratory test, there were leukocytosis and increasing of D-Dimer. From ECG we found McGinn White Sign. Based on echocardiography, we found RV/LV basal ratio > 1 accompanied by Mc Connel sign and decreased right ventricular systolic function. Discussion Echocardiography is one of diagnostic modalities that is very useful for making a diagnosis, where the use of echocardiography is more accessible than computer tomography (CT) as the gold standard. In this case, by using echocardiography especially in intensive rooms, the diagnosis of pulmonary embolism can be established faster in high risk patients. The prognosis of pulmonary embolism is very dependent on the speed at which the diagnosis is made.