CTICasesAcute Severe Pulmonary Embolism Requiring Surgical Embolectomy
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Imaging findings
Radiograph showed marked enlargement of the heart, specifically the right atrium and ventricle, along with distension of the azygos vein and SVC, indicative of elevated CVP. Echocardiogram described a 'worm-like' mobile structure in the right atrium prolapsing through the tricuspid valve into the ventricle. A ventilation-perfusion scan showed numerous perfusion defects in both lungs, with only small areas of residual perfusion, indicating dramatic abnormality.
Key takeaways
This is a dramatic case of acute severe pulmonary embolism, confirmed by surgical embolectomy, which revealed emboli in the right atrium and both pulmonary arteries. Such severe PE can lead to pulmonary hypertension and significant cardiac strain. Surgical embolectomy is considered for severe cases, especially when there's an allergy to contrast preventing a CTPA, or when conservative management is insufficient.
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See all cases from January 14, 2016 →