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(Circulation. 2008;117:585-587.)
© 2008 American Heart Association, Inc.

Images in Cardiovascular Medicine

Pulmonary Embolism Due to Popliteal Venous Aneurysm

Hiroshi Ikenouchi, MD; Yasuyuki Sugishita, MD; Fumiko Tabei, MD; Nobuhiko Itoh, MD; Akira Nozaki, MD; Satoshi Tanaka, MD; Katsuhiko Kasahara, MD; Satoshi Kamata, MD

From the Departments of Cardiology (H.I., Y.S., F.T., N.I., A.N.) and Cardiovascular Surgery (S.T., K.K., S.K.), Kanto Central Hospital, Tokyo, Japan.

Correspondence to Hiroshi Ikenouchi, MD, 6–25–1 Kamiyouga, Setagaya-ku, Tokyo 158–8253, Japan. E-mail hikenouchi-ind@umin.ac.jp

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A 33-year-old man was admitted to our hospital for shortness of breath on exertion. His symptoms started suddenly a week before admission when he was driving a car and worsened daily. He was amateur football player and had no history of hypertension, dyslipidemia, diabetes mellitus, smoking, or leg injury. On admission, an arterial pulse oxygen saturation monitor showed that his arterial blood oxygen saturation was 94% with room air. His blood pressure was 114/82 mm Hg and his pulse rate was 92/min with regular rhythm. His height was 162 cm and body weight was 62 kg. No other outstanding physical abnormalities were observed. Laboratory data showed slightly an elevated C-reactive protein level of 0.87 mg/dL with a normal white blood cell count of 6100 cells/mL. Arterial blood sampling revealed a normal CO₂ level of 41 mm Hg and pH of 7.42 with low oxygen tension (52 mm Hg). An ECG showed a small S wave in lead I and a small Q wave and inverted T wave in lead III. Cardiac ultrasound examination (Figure 1) revealed dilated right ventricle and compressed interventricular septum. For further diagnosis, we performed an enhanced chest computed tomography scan and pulmonary arteriogram. The patient was diagnosed with a pulmonary embolism (Figures 2 and 3). His pulmonary arterial pressure was 40/16 mm Hg and cardiac index was 2.9 L · min^–1 · m^–2. A blood sample test showed normal protein C and protein S concentrations. Lupus anticoagulant and anti-cardiolipin antibody tests . . . [Full Text of this Article]