CTChestIntermediate

Pulmonary embolism (CTPA)

chestvascularCTPAthromboembolismright heart strainemergency

Clinical presentation

Post-operative patient with acute pleuritic chest pain, dyspnoea, tachycardia and a raised D-dimer.

Key imaging findings

  • Filling defect (polo-mint / railway-track sign) within an opacified pulmonary artery on CTPA
  • Acute emboli form acute angles with the vessel wall and are central
  • Right heart strain: RV:LV ratio > 1, septal bowing toward the left
  • Possible wedge-shaped peripheral infarct (Hampton hump on radiograph)

Form your diagnosis, then reveal the answer.

Educational teaching content only. Imaging appearances vary; always correlate clinically and confirm with a qualified radiologist.