Saddle Pulmonary Embolism: An Unlikely Finding on Transesophageal Echocardiography

Saddle pulmonary embolism on transesophageal echocardiogram.

Transthoracic echocardiography is used frequently in the management of pulmonary embolism, but transesophageal studies are seldom used in this context. In this case, we describe a saddle pulmonary embolism which was incidentally discovered on transesophageal echocardiography prior to synchronized cardioversion and subsequently prompted successful percutaneous mechanical thrombectomy.

Echocardiographers should remain aware of the close proximity between the left atrial appendage and main pulmonary artery to catch incidental findings. Examination of the pulmonary artery bifurcation was successfully performed in this case in the mid-esophageal position at approximately 0-degrees with anteflexion.