Presentation
Underlying antiphospholipid syndrome. Presented with sudden onset of dyspnea and chest discomfort. Raised D-Dimer.
Patient Data
Extensive bilateral pulmonary emboli seen at the bifurcation extending to the left main pulmonary artery and its branches as well as in the right interlobar artery extending to the right lower lobe pulmonary artery and its segmental branches.
Mild dilatation of the right ventricle with flattening of the interventricular septum suggestive of right heart strain. Reflux of contrast seen into the inferior vena cava and hepatic veins.
No evidence of pulmonary infarct or hemorrhage.
Case Discussion
Patients with antiphospholipid syndrome have circulating antiphospholipid antibodies that cause a hypercoagulable state, leading to vascular thrombosis.
This patient had a previous history of superior mesenteric artery thrombosis, however she defaulted anticoagulant treatment for the past 2 years.
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