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Right ventricular outflow obstruction from thrombus with small peripheral pulmonary emboli
Chest
|February 1, 1981
Summary
Massive pulmonary embolism can occur despite normal pulmonary angiograms. Autopsy revealed a large clot obstructing the right ventricle, suggesting alternative imaging for diagnosis.
Area of Science:
- Cardiology
- Radiology
- Pathology
Background:
- Pulmonary embolism (PE) is a critical condition often diagnosed via pulmonary angiography.
- Diagnostic challenges arise when standard imaging fails to confirm suspected PE.
Observation:
- A patient presented with clinical signs of massive pulmonary embolism.
- Initial pulmonary angiography revealed normal pulmonary arteries.
- Necropsy identified a large thrombus obstructing right ventricular outflow.
Findings:
- The case highlights a discrepancy between clinical suspicion of PE and angiographic findings.
- Autopsy confirmed a massive right ventricular outflow tract obstruction due to a thrombus.
Implications:
- Suggests considering right atrial or right ventricular angiography in specific PE cases.
- Emphasizes the importance of considering alternative diagnostic approaches when initial tests are inconclusive.
- Highlights potential limitations of pulmonary angiography in diagnosing certain massive PE presentations.