Whenever PE is identified, the signs of right heart strain must be assessed for:
- flattening of the interventricular septum or when more severe bowing of the interventricular septal towards the left ventricle
- enlarged right ventricle (compared with the left ventricle)
- enlarged pulmonary trunk (compared with the ascending aorta on the same axial slice
- dilated hepatic veins +/- contrast reflux
- inferior vena caval enlargement +/- contrast reflux
- dilated azygous vein