PMC6178910_01
EKG showing deep T wave inversions in leads V1-V6 and the inferior limb leads.
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EKG showed deep T wave inversions in leads V1-V6 and the inferior limb leads ( Figure 1).
Repeat EKG now showing a Q
3T
3 pattern in lead III.
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III ( Figure 2). In view of these new findings (low oxygen saturation and a change in the EKG pattern), a computerized tomography of the chest with angiogram (chest CTA) was ordered.
Axial CTA of the chest showing a saddle embolus with extension into the branches of the pulmonary artery.. CTA was performed using Siemens SOMATOM Perspective 128 slices. Images were obtained in a cranio-caudal direction following contrast injection at 3mls/s. Contrast optimization was based on bolus tracking at the level of the main pulmonary artery using a trigger level of 100 HU.
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This revealed a saddle pulmonary embolus which extended into the right and left pulmonary arteries and involved all lobar branches of the pulmonary arteries ( Figure 3).