PMC2810585_01
Electrocardiogram at the time of admission showed an SI, QIII, TIII pattern.
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F1
The electrocardiogram (ECG) demonstrated sinus tachycardia and an SI, QIII, TIII pattern (Fig. 1) suggestive of pulmonary embolism.
Apical four-chamber view of the echocardiogram demonstrated marked dilatation of the right ventricle and right atrium. The interventricular septum and the atrial septum were deviated towards the left ventricle and left atrium respectively. RV, right ventricle; RA, right atrium; LV, left ventricle; LA, left atrium.
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F2
Echocardiography showed a small left atrium (left atrial diameter, 26 mm) with marked dilatation of the right atrium (Fig. 2).
A. Contrast-enhanced CT performed at the level of the right main pulmonary artery showed a large emboli in the bilateral main pulmonary arteries. B. Contrast-enhanced CT performed at the level of the descending interlobar pulmonary arteries showed low-attenuation emboli outlined by high attenuation contrast-enhanced flowing blood.
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F3
Toshiba, Tokyo, Japan) demonstrated large clots in the pulmonary arteries (Fig. 3). The right atrium and right ventricle were dilated, but a marked diastolic collapse of the left atrium was noted (Fig. 4).
Contrast-enhanced CT at the mid-ventricular level showed that the interventricular septum was straightened and the right ventricle and right atrium were dilated, indicating a raised pressure on the right side of the heart. The left atrium was markedly decreased in size, indicating underfilling of the left side of the heart. The region of interest was determined using contrast-enhanced CT scans. Each area (1 = right atrium; 2 = left atrium) was multiplied by its slice thickness (8 mm) and the results were added together using the workstation (Fiji Photo Film Co., Ltd., Tokyo, Japan).
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F4
Toshiba, Tokyo, Japan) demonstrated large clots in the pulmonary arteries (Fig. 3). The right atrium and right ventricle were dilated, but a marked diastolic collapse of the left atrium was noted (Fig. 4). Tokyo, Japan), multiplying each area by its slice thickness (8 mm) and adding the results together (Fig. 4). The right atrial volume was 124 mL (Normal: 110-185 mL), but the left atrial volume markedly decreased to 53 mL (Normal: 100-130 mL).