Thorax 1998;53:1092-1094 ( December )

Case report

Interventricular septal shift due to massive pulmonary embolism shown by CT pulmonary angiography: an old sign revisited T B Oliver,^a J H Reid,^b J T Murchison^c

^a Department of Clinical Radiology, University Hospital of Wales, Cardiff, UK, ^b Department of Radiology, Borders General Hospital, Melrose, UK, ^c Department of Clinical Imaging, Royal Infirmary of Edinburgh, Edinburgh, UK

Correspondence to: Dr JT Murchison, Department of Clinical Imaging, Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh. EH3 9YW, UK.

Received 5 March 1998; Returned to authors 13 May 1998; Revised version received 3 July 1998; Accepted for publication 20 August 1998

The computed tomographic (CT) pulmonary angiogram appearances of acute right ventricular dysfunction due to massive pulmonary embolus in a patient are described. Abnormal findings comprised right ventricular dilatation, interventricular septal shift, and compression of the left ventricle. These changes resolved following thrombolysis. Use of CT pulmonary angiography to diagnose pulmonary emboli is increasing. Secondary cardiac effects are established diagnostic features shown by echocardiography. These have not been previously described but are important to recognise as they may carry important prognostic and therapeutic implications.

Keywords: pulmonary embolism; right ventricular dysfunction; spiral computed tomography; pulmonary angiography

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© 1998 by Thorax
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