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Pulmonary (Thrombo)Embolism and CT Pulmonary Angiography

CXR: Normal or
- Westermark sign: Focal peripheral lucency beyond occluded vessel
- Enlargement of the central pulmonary artery, sausage-like configuration
- Atelectasis
- Hampton hump: Focal airspace opacification due to infarction
- Melting Ice Cube Sign: Resolving pulmonary infarct
- Pulmonary effusion
- Diaphragmatic elevation
- To rule out: PMX, pulmonary edema, pneumonia, rib fx

Duplex Doppler US may be obtained before CTAP to r/o DVT in suspected cases. If positive, treatment may be initiated w/o CTAP.

may be oversensitive for small potentially clinically unimportant emboli

"Possible small subsegmental pulmonary embolism identified on a low quality examination, significantly degraded by respiratory motion"

Right ventricular strain: RV enlargement, RV wall motion abnormalities, leftward bowing of the interventricular septum