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Pulmonary embolism

Case contributed by Mohammed Saleem Luhar
Diagnosis almost certain

Presentation

SCC tongue on chemoradiotherapy, left leg DVT, pleuritic chest pain, shortness of breath and tachycardia. Wells score 8.5, Revised Geneva score 14

Patient Data

Age: 65 years
Gender: Female
x-ray

Normal cardio-mediastinal contour other than mild prominence of central pulmonary arteries with relative pruning of peripheral vessels. Normal Lung parenchyma.

ct

Good contrast opacification of the pulmonary arteries. There are filling defects bilaterally in the lobar, segmental and subsegmental pulmonary arteries - In keeping with pulmonary emboli. No evidence of right heart strain. Subpleural atelectasis in the left base. Incidental large hiatus hernia with proximal stomach lying in the thorax.

Case Discussion

In keeping with acute bilateral pulmonary embolism without right heart strain.

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