PMC9957573_01
A chest X-ray showing right-sided lower lobe consolidation with an air bronchogram.
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FIG1
An anterior-posterior chest X-ray revealed a right lower lobe consolidation with an air bronchogram (Figure 1).
Electrocardiogram showing normal sinus rhythm without acute ischemic changes.
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FIG2
Cardiac POCUS using the short-axis left parasternal view showing flattening of the interventricular septum and giving rise to the D-shaped left ventricle (D-sign), which is seen in patients with right ventricular strain.. POCUS, point-of-care ultrasound
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FIG3
Unexpectedly, it showed RV strain with D-shaped left ventricle and lung B-lines with subpleural consolidations, not previously seen on admission (Figures 3-4).
Panel A shows a patient's normal lung POCUS in the left upper lung anteriorly before the development of the new left-sided pleuritic chest pain. Panel B shows lung POCUS during the evaluation of the new left-sided pleuritic chest pain around the same lung area, and it shows new triangular-shaped subpleural consolidation with an associated B-line suggesting new interstitial process, including pulmonary embolism.. POCUS, point-of-care ultrasound
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FIG4
Unexpectedly, it showed RV strain with D-shaped left ventricle and lung B-lines with subpleural consolidations, not previously seen on admission (Figures 3-4).
CTPA showing bilateral pulmonary emboli (red arrows).. CTPA, computed tomography pulmonary angiography
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FIG5
The D-dimer level was elevated at 1,453 D-dimer units (DDU) ng/mL and subsequent CTPA confirmed the presence of bilateral pulmonary emboli in the left and right upper lobes but greater in the left (Figure 5).