Presentation
Collapse at home.
Patient Data
Satisfactory opacification of the pulmonary artery.
ETT well positioned. Large saddle embolus is noted, extending into the lobar pulmonary arteries bilaterally. Right heart strain is noted, with enlargement of the RV, bulging of the interventricular septum and small amount of reflux of contrast into the hepatic veins. Minor left lingula atelectasis. No pleural or pericardial effusion. Enlarged mediastinal lymph node measures 12 mm in the short axis, at the aortopulmonary window. Imaged upper abdominal organs are unremarkable. No suspicious osseous lesion.
Conclusion: Large saddle embolus, with evidence of right heart strain. Team was present at time of scanning.
Case Discussion
A saddle pulmonary embolism commonly refers to a large pulmonary embolism that straddles the bifurcation of the main pulmonary artery, extending into the left and right pulmonary arteries.
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