case_images: PMC5509188_01
case_images: The electrocardiogram on arrival shows sinus tachycardia, incomplete right bundle branch block, left atrial enlargement, an S wave in lead I and a Q wave in lead III, T wave inversion in leads V1-V3, ST elevation in leads aVR and V1, and ST depression in leads I, II, III, aVF, and V4-V6, indicating hemodynamic instability from an acute pulmonary embolism (a). The electrocardiogram after hospital discharge reveals resolution of T wave inversion in leads V1-V3 and incomplete right bundle branch block, suggesting recovery from the right ventricular dysfunction (b)
case_images: TCMJ-29-50-g001.jpg
case_images: PMC5509188_01_TCMJ-29-50-g001.jpg
case_images: F1
case_images: His ECG showed sinus tachycardia, left atrial enlargement, an S wave in lead I, a Q wave in lead III, incomplete RBBB, TWI in leads V1-V3, STE in leads aVR and V1, and STD in leads I, II, III, aVF, and V4-V6, [Figure 1a]. A subsequent ECG in our outpatient department (OPD) showed resolution of TWI in leads V1-V3 and incomplete RBBB [Figure 1b].
case_images: Computed tomography pulmonary angiography discloses large emboli in the left and right pulmonary arteries (a) and the right ventricle/left ventricle diameter ratio is abnormally increased to 1.22 (b), confirming the diagnosis of acute massive pulmonary embolism
case_images: TCMJ-29-50-g002.jpg
case_images: PMC5509188_01_TCMJ-29-50-g002.jpg
case_images: F2
case_images: CTPA confirmed massive emboli in the left and right PAs [Figure 2a] and showed the RV/left ventricle (LV) diameter ratio was abnormally increased to 1.22 [Figure 2b].