Presentation
3 days of SOB and chest tightness
Patient Data
Age: 50 years
Gender: Female
From the case:
Chronic pulmonary embolus
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Axial C+ CTPA

Peripheral non-occlusive filling defect within the left basal lateral segmental pulmonary artery. The peripheral distribution of the filling defect within the vessel signifies chronic PE rather than acute embolism. No signs of RV strain.
Case Discussion
The location of the filling defect in a pulmonary artery gives a clue to the acuity of embolus:
- acute PE tends to be central whereas;
- chronic PE tends to be eccentric or peripheral, adherent to the wall of the vessel