"The Great Masquerader": An Interesting Case Series of Pulmonary Thromboembolism

Figures

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  Figure 1. Standard 12-lead ECG showing sinus tachycardia, incomplete right bundle branch block, "S1Q3T3 pattern".

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  Figure 2. 2D echo showing a dilated right atrium and right ventricle with a displaced interventricular septum (red arrows), "D-shaped left ventricle" and McConnell’s sign (yellow arrow).

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  Figure 3. CT pulmonary angiogram showing a large intraluminal filling defect in the main pulmonary artery extending into the right and left pulmonary arteries causing near complete occlusion of the lumen (red arrows)

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  Figure 4. CT pulmonary angiogram showing partially occluding hypodense filling defects in right and left pulmonary artery and in segmental divisions (red arrows).

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  Figure 5. Inferior vena cava filter in the infra-renal position (red arrows). This reduces the chance of filtered thrombus occluding the renal vein.

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  Figure 6. Standard 12-lead ECG showing sinus tachycardia of 142 beats per minute, S1Q3T3 pattern, right ventricular strain with T-wave inversion in V1-V4.

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  Figure 7. CTPA showing hypodense filling defects noted in the distal part of right and left pulmonary artery extending into the segmental branches.

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  Figure 8. ECG showing sinus tachycardia and S1Q3T3 pattern

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  Figure 9. ECG showing sinus tachycardia, "S1Q3T3 pattern", and T-wave inversion in chest leads (V1-V6) and inferior leads.

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  Figure 10. 2D echo showing thrombus across tricuspid valve (cyan arrows) and RV thrombus (pink arrows).

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  Figure 11. Irregular filling defects in right and left pulmonary artery (red arrows), intraluminal filling defect extending to the right ventricle (pink arrows).

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  Figure 12. Integrated diagnostic approach for acute PE