PMC6458947_01
(a) Right ventricular size and function assessment was done with RV focused imaging from apical four chamber view. Initial measurement showed 5.03 cm RV basal diameter consistent with moderately dilated RV size. 2D images also showed reduced RV ejection fraction along with RV strain findings. (b) Right ventricular size and function assessment was done with RV focused imaging from apical four chamber view. RV basal diameter is measured as 4.44 cm which was consistent with mildly dilated RV size. RV ejection fraction is improved, and RV strain findings were no longer available.
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fig1
A repeat TTE showed a PASP of 54 mmHg with new moderate dilatation of the RV and moderate tricuspid regurgitation (Figure 1(a)) with a serum troponin T of 0.204 ng/mL and proBNP of 445 pg/mL. TTE three days after thrombolytic therapy demonstrated a PASP of 32 mmHg with mild dilation of the RV without signs of strain (Figure 1(b)). The patient was weaned from mechanical ventilation and later discharged to a skilled nursing facility for rehabilitation on oral apixaban for three months with outpatient follow-up provided.
CT Chest demonstrating embolus in the right main pulmonary artery.
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fig2
Chest CT angiogram revealed large embolus in the right main pulmonary artery (Figure 2).