PMC3327015_01
Echocardiogram: parasternal short-axis view at the base of the heart with color Doppler showing thrombus in the right pulmonary artery
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F1
The flow to the left pulmonary artery was sluggish [Figure 1].
CT angiogram showing acute pulmonary thrombus involving the right and left pulmonary arteries with nonvisualization of their branches (marked by red color arrows)
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F2
A CT scan of the chest with angiography confirmed the presence of a thrombus completely occluding the right pulmonary artery and the lobar branches of the left pulmonary artery [Figure 2].
Echocardiogram with color Doppler after thrombolytic therapy; the thrombus is dissolved with normal pulmonary artery flow
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F3
Serial echocardiograms demonstrated completely dissolved thrombi in both the pulmonary arteries with normalization of pulmonary pressure and left to right shunt across the ASD at the end of 36 hours [Figure 3].
Post-thrombolytic therapy pulmonary perfusion scan - residual segmental perfusion defects involving the apical segment of the right lower lobe and inferior lingual segment of the left lung
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F4
Prior to discharge, a lung perfusion scan was obtained which showed patchy residual segmental perfusion defects in both the lung fields [Figure 4].
PMC3327015_02
Echocardiogram showing thrombus in the left pulmonary artery with some antegrade flow in it
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F5
There was a single thrombus (3 x 5 mm) in the proximal left pulmonary artery with slightly decreased distal flow [Figure 5].
Chest CT angiogram showing thrombus in the left pulmonary artery
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F6
A chest CT with angiogram confirmed this [Figure 6].