Pulmonary embolism

Case contributed by Dr Allam Harfoush


Sudden shortness of breath, chest discomfort and palpitation.

Patient Data

Age: 55 years
Gender: Female
  • hyper-dynamic left ventricle
  • right ventricle dilation with reduced longitudinal function (TAPSE=11mm)
  • severe tricuspid regurgitation
  • right ventricular systolic pressure is 58mmHg
  • D-shape on short-axis view
  • leftward ventricular septal bowing (LVSB)
  • McConnell sign

Case Discussion

Vital signs (heart rate: 120/minute; respiratory rate: 35/minute; blood pressure: 110\60 mmHg; O2 saturation: 86%) were abnormal. D-dimer was four times the cut-off value. 

The diagnosis was confirmed with CTPA showing a sub-massive pulmonary embolism.

The patient was admitted to the intensive care unit (ICU), the initial management included non-invasive ventilation, oxygen and anti-coagulation.

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