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Saddle embolus with right heart strain

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Middle aged female severely short of breath with low oxygen saturation.

Patient Data

Age: 55 years
Gender: Female
Race: Asian

Thrombus 'hanging' over the pulmonary bifurcation in keeping with a saddle embolus.

Multiple additional emboli in the lobar and segmental pulmonary arteries.

Straightening of the intraventricular septum.

Case Discussion

Pulmonary emboli are common.  The nature can vary considerably, the most extreme example being a saddle embolus.

With central and high volume pulmonary emboli, right heart strain may occur, which may be identified on CT as straightening of the intraventricular septum.

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