PMC9259549_01
Chest X-ray showing bilateral lung opacities.
CRICC2022-3483605.001.jpg
PMC9259549_01_CRICC2022-3483605.001.jpg
fig1
Chest X-ray showed bilateral opacities consistent with multifocal pneumonia (Figure 1).
Chest computed tomography with contrast showing bilateral pulmonary emboli and multifocal lung consolidations.
CRICC2022-3483605.002.jpg
PMC9259549_01_CRICC2022-3483605.002.jpg
fig2
Chest computed tomography with contrast (CTA) showed numerous acute segmental pulmonary emboli in the right upper, right lower, left upper, and left lower lobe pulmonary arteries as well as flattening of the intraventricular septum suggestive of right heart strain (Figure 2).
Electrocardiogram showing supraventricular tachycardia and the S1Q3T3 pattern (deep S waves in lead I and Q waves and T wave inversion in lead 3).
CRICC2022-3483605.003.jpg
PMC9259549_01_CRICC2022-3483605.003.jpg
fig3
An EKG at the time showed supraventricular tachycardia as well as an S1Q3T3 pattern indicative of acute right heart strain (Figure 3).
Echocardiogram in the short axis view showing the clot in transit in the right ventricle (star).
CRICC2022-3483605.004.jpg
PMC9259549_01_CRICC2022-3483605.004.jpg
fig4
A transthoracic echocardiogram (TTE) was obtained and showed severely enlarged right ventricle with reduced systolic function and evidence of right ventricular strain, moderate tricuspid valve regurgitation, and a mobile echodensity in the right ventricle attached to the tricuspid valve consistent with a clot in transit (Figure 4).