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Normal lung perfusion scan with extensive thromboembolic disease.
Chest
|September 1, 1987
Summary
A lung perfusion scan may miss pulmonary hypertension caused by blood clots. Extensive thromboembolic disease requires considering anticoagulation when scans are inconclusive.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Pathology
Background:
- Pulmonary hypertension diagnosis can be challenging.
- Distinguishing primary from secondary causes is critical for treatment.
Observation:
- A patient with unexplained pulmonary hypertension showed normal lung perfusion scan results.
- Open lung biopsy revealed organized thrombi, and autopsy confirmed extensive thromboembolic disease.
Findings:
- A six-view lung perfusion scan may not differentiate primary pulmonary hypertension from thromboembolic hypertension.
- Diffuse, symmetrical thrombi can lead to misleading scan results.
Implications:
- In cases with high-risk invasive procedures, empiric anticoagulation is a viable consideration.
- This highlights the limitations of non-invasive imaging in specific thromboembolic scenarios.