CTICasesTricuspid Valve Infective Endocarditis with Septic Pulmonary Embolism (Palla's Sign)
Imaging findings
Chest radiograph shows marked dilation of the right descending pulmonary artery. Chest CT reveals large, irregular vegetations on a prosthetic tricuspid valve and massive, occluding thromboembolic filling defects within the right main and descending pulmonary arteries. This focal enlargement of the descending pulmonary artery due to acute emboli represents a classic Palla's sign.
Key takeaways
Right-sided infective endocarditis, often associated with intravenous drug use or prosthetic valves, frequently embolizes to the lungs, presenting as septic pulmonary emboli, pulmonary infarction, or massive pulmonary artery occlusion. Palla's sign is a classic radiographic sign referring to a dilated right descending pulmonary artery due to acute pulmonary embolism.
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