Pulmonary emboli, right ventricular strain and incidental double SVC

Case contributed by Dr Craig Hacking

Presentation

New chest pain, recent craniotomy for primary CNS tumour

Patient Data

Age: 65
Gender: Male

Multiple pulmonary artery filling defects are seen in bilateral lobar and segmental branches in keeping with multiple pulmonary emboli. Mild enlargement of the right ventricle and bowing of the interventricular septum in keeping with RV strain. Mild cardiomegaly.

Incidental double SVC, with the left SVC draining into the mildly enlarged coronary sinus (a normal anatomic variant). No pericardial effusion. No hilar or mediastinal lymphadenopathy. Patchy atelectasis in the lung bases. No pleural effusion.

The upper abdominal viscera are unremarkable. No focal bone abnormality.

Conclusion

  1. Multiple lobar and segmental PEs (moderate burden) with signs of right heart strain.
  2. Incidental double SVC.
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Case Information

rID: 40183
Case created: 11th Oct 2015
Last edited: 7th Nov 2015
Systems: Chest, Vascular
Inclusion in quiz mode: Included

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