case_images: PMC4887829_01
case_images: Electrocardiogram on presentation showing sinus tachycardia with a heart rate of 115 beats per minute, T wave inversions in leads III and V3.
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case_images: OMW045F1
case_images: Her electrocardiogram (Fig. 1) on presentation showed sinus tachycardia with a heart rate of 115 beats per minute, T wave inversions in leads III and V3 and chest X-ray showed a widened superior mediastinum (Fig. 2).
case_images: Echocardiogram: apical four-chamber view showing dilated right ventricle (RV). RA, right atrium; LA, left atrium; LV, left ventricle.
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case_images: PMC4887829_01_omw04503.jpg
case_images: OMW045F3
case_images: It showed moderate to severe RV enlargement, moderately hypokinetic right ventricle, abnormal atrial and ventricular and septal motion and mild pulmonary hypertension (Fig. 3).
case_images: CT of the chest showing saddle emboli (white arrows) in main pulmonary artery (MPA), right pulmonary artery (red arrow) and left pulmonary artery (LPA). AA, ascending aorta; SVC, superior vena cava; DA, descending aorta.
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case_images: OMW045F4
case_images: Computed tomography (CT) of the chest with intravenous contrast (Fig. 4) confirmed our diagnosis of acute PE and showed 'saddle embolus' involving the main pulmonary artery extending into both right and left pulmonary arteries and associated secondary and tertiary branches.  
case_images: Gross specimen of saddle pulmonary embolus.
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case_images: PMC4887829_01_omw04505.jpg
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case_images: Patient underwent pulmonary embolectomy, and large saddle embolus was removed (Figs 5 and 6).
case_images: Histopathology of pulmonary thromboemboli.
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case_images: PMC4887829_01_omw04506.jpg
case_images: OMW045F6
case_images: Patient underwent pulmonary embolectomy, and large saddle embolus was removed (Figs 5 and 6).