Keywords:
Embolism / Thrombosis, Screening, CT-Angiography, Cardiovascular system
Authors:
B. Özkul, N. Inan, �. Özkul, H. T. Sarisoy, G. Akansel, A. Akça, �. Çam; Kocaeli/TR
DOI:
10.1594/esti2014/P-0085
Imaging findings OR Procedure details
A 79 years old male patient was evaluated for chest pain and breathlessness at the emergency room.
He has been chronic renal failure since 1996 and he had no history of invasive cardiac procedures. Cardiac markers and D-dimer test,
electrocardiography,
echocardiography and chest MDCT were performed.
MDCTA scanning protocol:
Examination revealed that no breath sound at the middle and lower zones of right lung and increased blood d-dimer levels (1.83 ng/mL,
normal: 0-0.5 ng/mL).
The creatinin was 3.88 mg/dL (normal: 0.6-1.3 mg/dL) and blood urea nitrogen was 34 mg/dL (normal: 7-25.7 mg/dL). A chest CT was performed because of the suspicious of pulmonary embolism.
Massive unilateral pleural effusion,
atelectasis and CST were seen in the chest CT (Fig. 3,
Fig. 4 and Fig. 5).
![](https://epos.myesr.org/posterimage/esr/esti2014/125149/media/586525?maxheight=300&maxwidth=300)
Fig. 3: Axial view of chest CT
References: Department of Radiology, Kocaeli University School of Medicine, Kocaeli/Turkey 2014
Also ST elevations in the ECG and increased cardiac markers were revealed (myoglobin: 355 ng/mL (normal: 0-107 ng/mL),
Troponin I: 0.85 ng/mL (normal: 0-0.4 ng/mL)).
Based on these findings,
a diagnosis of acute MI depending on CST was made.
![](https://epos.myesr.org/posterimage/esr/esti2014/125149/media/586526?maxheight=300&maxwidth=300)
Fig. 4: Coronal view of chest CT
References: Department of Radiology, Kocaeli University School of Medicine, Kocaeli/Turkey 2014
![](https://epos.myesr.org/posterimage/esr/esti2014/125149/media/586527?maxheight=300&maxwidth=300)
Fig. 5
References: Department of Radiology, Kocaeli University School of Medicine, Kocaeli/Turkey 2014