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Saddle pulmonary embolism which is straddling the pulmonary bifurcation and extending into the left and right pulmonary arteries.
Signs of right heart strain in the form of :
- dilatation of the right ventricle (RV) (i.e. RV width > left ventricular width)
- straightening with mild leftward bulging of the interventricular septum
- enlargement of the pulmonary trunk