Large pulmonary embolism with right heart strain

Case contributed by Dr Andrew Dixon


Shortness of breath and sudden rise of troponin.

Patient Data

Age: 60
Gender: Male

Extensive pulmonary emboli within the main pulmonary arteries bilaterally extending into the upper lobe, middle lobe and lower lobe divisions.  Much of the thrombus is nonocclusive, with occlusive thrombus involving the left upper lobe lingula and right middle lobe medial segment branches. There is associated dilatation of the right heart with bulging of the interventricular septum consistent with right heart strain.  A solitary nonspecific 3 mm nodule is identified in the right lung apex otherwise the lungs are clear. 

Case Discussion

Large volume pulmonary embolism with thrombus within the left and right pulmonary arteries extending into all lobar divisions. Associated features of right heart strain

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Case information

rID: 36508
Published: 2nd May 2015
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included

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