Presentation
Cardiac MRI for pulmonary hypertension to rule out cardiac defects or shunts.
Patient Data
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Enlarged pulmonary trunk, lungs and pleural spaces are clear.
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Bilateral segmental pulmonary artery emboli.
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Bilateral pulmonary artery emboli.
Signs of right heart strain are noted:
straightening of the interventricular septum
dilated pulmonary artery, in keeping with the development of pulmonary hypertension
contrast medium reflux into dilated IVC and hepatic veins
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Bilateral major mismatched defects consistent with high probability pulmonary embolism.
Case Discussion
The patient was started on thrombolytic therapy and followed up by CTPA which demonstrated persistent bilateral pulmonary emboli without significant interval changes.