Pulmonary embolism

Case contributed by Hani Makky Al Salam

Presentation

Cardiac MRI for pulmonary hypertension to rule out cardiac defects or shunts.

Patient Data

Age: 20 years
Gender: Male

Chest Radiograph

x_ray

Enlarged pulmonary trunk, lungs and pleural spaces are clear. 

Cardiac MRI

mri

Bilateral segmental pulmonary arteries emboli. 

CTPA

ct

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 arterial hypertension
  • dilated IVC and hepatic veins

V/Q scan

Nuclear medicine

Bilateral major mismatch defect consistent with high probability pulmonary embolism. 

Case Discussion

The patient was started on thrombolytic therapy and followed up by CTPA which demonstrated the bilateral emboli without significant interval changes.

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