CTICasesInfected Right Ventricular Thrombus mimicking CTEPH
Imaging findings
CT in an intravenous drug user shows multiple proximal filling defects in the central and peripheral pulmonary arteries resembling chronic thromboembolic disease. An older CT confirms a large infective vegetation on the tricuspid valve, representing infected emboli. Findings of IV talcosis are also suspected.
Key takeaways
Right-sided infective endocarditis with large tricuspid vegetations can embolize to the pulmonary arteries. These infected emboli can cause vascular destruction and lumen scarring that mimics CTEPH but is not amenable to pulmonary endarterectomy.
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