CT Pulmonary Angiography-May Reveal Pulmonary Embolism, But Always Look at the Heart!
Department of Radiology, Tel Aviv Medical Center (affiliated with the Sackler Faculty of Medicine, Tel Aviv University), Israel
A 76 year old female, smoker with a distant history of CABG, and recent myocardial infarction with PCI, on anticoagulation. The patient presented with a new 5 cm right upper lobe mass, which showed high FDG avidity on PET-CT. She underwent right upper lobectomy, which went uneventful.
However, 3 days following the surgery, she developed severe dyspnea. On CT pulmonary angiography (CTPA), segmental PE was diagnosed and so, anticoagulation was continued. Due to persistent hemodynamic instability, she had two repeat CTPA scans, only the second leading to the diagnosis of a pseudoaneurysm of the left ventricle.
Our message is to never neglect careful evaluation of the heart when reviewing the chest!