case_images: PMC10808894_01
case_images: ECG showed the Zurkurnai ECG pattern defined as right axis deviation, poor R wave progression, biphasic deep T inversion on V2-V5 and limb leads, maximum at V3
case_images: cureus-0016-00000052889-i01.jpg
case_images: PMC10808894_01_cureus-0016-00000052889-i01.jpg
case_images: FIG1
case_images: T inversion at V2-V4 (Figure 1). There was also the presence of minimal T inversion in leads II, III, and AVF as compared to the precordial lead.
case_images: Transthoracic echocardiography of the short axis view showed a D-shaped left ventricle with a dilated right ventricle size secondary to pulmonary hypertension. Transthoracic apical 4 chamber view showed the presence of right ventricular free wall akinesia and hyperkinetic of the RV apex suggestive of McConnell's sign, which is specific to acute pulmonary embolism. Transthoracic echocardiography of the RV inflow view showed the presence of mobile thrombus at the main pulmonary artery bifurcation
case_images: .jpg
case_images: PMC10808894_01_.jpg
case_images: VID1
case_images: Computed tomography pulmonary angiography confirmed the presence of saddle pulmonary thrombus at the bifurcation of the pulmonary trunk extending to the left pulmonary artery until subsegmental branches (Figure 2 and Figure 3).
case_images: Axial CPTA at the level of the main pulmonary artery bifurcation shadowing a large filling defect (labeled with an asterisk) straddling the main pulmonary artery extending to the right and left pulmonary arteries consistent with saddle embolism. Note the dilation of the pulmonary artery relative to the corresponding ascending aorta.. CPTA: CT pulmonary angiography
case_images: cureus-0016-00000052889-i02.jpg
case_images: PMC10808894_01_cureus-0016-00000052889-i02.jpg
case_images: FIG2
case_images: Computed tomography pulmonary angiography confirmed the presence of saddle pulmonary thrombus at the bifurcation of the pulmonary trunk extending to the left pulmonary artery until subsegmental branches (Figure 2 and Figure 3).