Presentation
Shortness of breath.
Patient Data
Age: 60
Gender: Male
From the case:
Saddle pulmonary embolism
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Extensive bilateral pulmonary emboli affecting all lobes with saddle emboli.
Normal calibre main pulmonary artery. Flattening of the intraventricular septum with mildly dilated right heart chambers. Reflux of contrast into the hepatic veins and IVC.
Mosaic attenuation (perfusion) of the right lung. Few areas of mosaic perfusion within the left upper lobe with oligaemia of the entire left lower lobe (note how small the pulmonary arteries are). A few small right suprahilar opacities may represent haemorrhage or infarct.
Case Discussion
Case illustrates many findings that can be seen in acute pulmonary embolus:
- Saddle embolus
- Right heart strain (dilated right heart chambers, flattening interventricular septum, reflux of contrast)
- Mosaic perfusion and oligaemia of lung parenchyma
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