Presentation
Shortness of breath over 6 weeks after recovery from a viral illness.
Patient Data
No focal consolidation appreciated. Nil pneumothorax. Nil bony abnormalities. Left rotation obscures the left hilar structures. Unable to appreciate the left costophrenic angle.
Proximal bilateral pulmonary emboli are appreciated. Multiple right side emboli with near complete occlusion extending to the lobar and segmental arteries. Similarly, the left side is remarkable for proximal emboli with interlobar extension.
Right interventricular septum bowing, pulmonary trunk enlargement and contrast reflux into the inferior vena cava are suggestive of right heart strain.
Additional findings include a small air cyst of the left lower lobe and nodule in the lingua.
Case Discussion
The patient reported chronic shortness of breath on exertion over a period of four to six weeks. Triggers for the pulmonary embolism included prolonged immobilization after a suspected viral illness. After extensive workup, the patient likely had a provoked pulmonary embolism in the absence of malignancy.
Pulmonary embolism can have a myriad of symptoms, in this case the only symptom was shortness of breath.
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