Pulmonary arteriography for pulmonary embolism diagnosis: "Old-fashioned", but it is still a valuable diagnostic tool

Pulmonary embolism (PE) is life-threatening disease, and sometimes clinical symptoms may be unspecific. We report a case of a previously healthy 70-year-old woman who presented syncope, chest pain, left bundle branch block on ECG and cardiogenic shock requiring vasopressor. Patient underwent cardiac catheterization for suspected acute coronary syndrome, however exam revealed normal arteries. Right side cardiac catheterization demonstrated elevate pulmonary artery pressure (50/37 mmHg) and angiography showed massive bilateral PE. An unsuccessful mechanically fragmentation was attempted, and patient died 6 hours later.