I was working today at one of our outpatient radiology offices, when the CT technologist asked me to take a look at the images on a 64 year old woman who had been sent over for a scan by her family practice doctor because she had been experiencing some recent shortness of breath and coughing.
When I pulled the images up on my workstation, I saw that she had massive bilateral pulmonary emboli (i.e., large clots obstructing the normal flow of blood to both her lungs). She had enormous clots on both sides, and was surviving on less than 50% of her normal pulmonary arterial flow.
I immediately ran back to the CT scanner suite, started her on oxygen, contacted her family doctor (who ordered the test), arranged emergency ambulance transport to the nearest ER, and coordinated with the charge nurse at the ER so that they’d be ready to receive her as soon as she hit the door. One of my partners subsequently told me that given the seriousness of her condition, if she had gone home, she probably would have died.
I’ve included 3 representative images from her recent CT scan (as well as a fourth normal comparison image from a different patient). On these images, the normal pulmonary arteries are white (due to the injected x-ray “dye”), and the blood clots show up as dark grey. These are the largest pulmonary emboli I’ve seen in about 3 years, and the largest ever in someone who wasn’t already in the hospital.
My adrenaline levels are just now starting to settle down.