The Virtual Hospital: ElectricPE: The Diagnosis of Pulmonary Embolism: Stroke

ElectricPE: The Diagnosis of Pulmonary Embolism: Case Study 19

Stroke

Jeffrey R. Galvin, M.D. and James J. Choi, B.S.
Peer Review Status: Internally Reviewed

This case is a 59 year old female alcoholic who presented to this hospital in a coma secondary to a stroke. Two months prior to admission she complained to her local physician of increasing shortness of breath and one episode of hemoptysis. A cardiac echo done at this hospital was read as normal.

The chest radiograph demonstrated cardiomegally and a right lower lung field mass. A chest CT showed that the mass was a wedge shaped pleural based lesion which suggested the presence of an infarct.

Mediastinal windows of the chest CT revealed a large thrombus in the right atrium.

Case Assessment
This was 59 year female alcoholic who had a long history of smoking. She presented with stroke, dyspnea and hemoptysis.

1. Most patients with pulmonary embolus have a predisposition. TEXT

2. Although the majority of pulmonary emboli come from the deep venous systems of the legs other sources are possible. We are discovering more intracardiac sources as non-invasive imaging techniques have improved.

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