Pulmonary embolism with right heart strain

Case contributed by Faisal Shadab
Diagnosis certain

Presentation

Sudden dyspnoea with sinus tachycardia. Low oxygen saturation.

Patient Data

Age: 70 years
Gender: Male

CT pulmonary angiogram shows extensive thrombi in the distal main right and left pulmonary arteries, also most of the lobar, segmental and subsegmental pulmonary artery branches on the right side.

Dilated right heart chambers with flattening of interventricular septum and contrast medium reflux into IVC and hepatic veins suggesting right cardiac strain.

Paraoesphageal hiatal hernia transmitting part of stomach and thoracic scoliosis are noted.

Case Discussion

Pulmonary embolism refers to embolic occlusion of the pulmonary arterial tree. There are many risk factors, commonly deep venous thrombosis of the lower limbs, immobilisation and surgery.

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