Clinics in diagnostic imaging (155)

Abstract

An obese 70-year-old man presented with an acute onset of chest pain and dyspnoea, as well as longstanding lower limb swelling. The patient had a background history of essential hypertension, hyperlipidaemia and ischaemic heart disease, and had undergone percutaneous coronary intervention in an overseas institution three years earlier. Transthoracic echocardiography found dilated pulmonary arteries with an estimated pulmonary arterial systolic pressure (PASP) of 51 mmHg, a reading higher than that expected for ischaemic cardiomyopathy or myocardial infarction. Chest radiography was performed (Fig. 1). Triple-rule-out (TRO) cardiacgated multidetector computed tomography (MDCT) (Fig. 2) was also performed to further investigate his symptoms and the disproportionate elevation of PASP. What do these images show? CMEArticleClinics in diagnostic imaging (155)