Diagnosis of Pulmonary Embolism: An Uncommon Cause of Pulmonary Embolism

Abstract

Diagnosis of pulmonary embolism (PE) could be challenging, especially in patients with non-specific symptoms such as dyspnoea and pleuritic chest pain, which can be difficult to differentiate from other less serious illnesses. Computed tomography pulmonary angiography (CTPA) is regarded as the gold standard imaging modality for investigation of acute PE nowadays, but transthoracic echocardiography is a cheap and innocuous tool, which can give us a lot of information in the hands of an expert operator, especially in the initial evaluation.

Multivisceral echinococcosis (ME) is defined by the simultaneous localization of hydatid cysts in more than one organ. Cases of ME with atypical localization are very rare but can have severe consequences and may even be fatal. We present here the case of a 50-year-old Maghrebian male patient with cysts located in mediastinum, pericardium, and right atrium (RA) with several serious complications over the years. He presented to the Emergency Department with chest pain and sudden dyspnoea. Echocardiogram showed an intracavitary thrombus in RA and a slight dilation of right ventricle (RV). Computed tomography and magnetic resonance imaging revealed ME and PE of hydatid origin. The diagnosis, clinical features, treatment, and follow-up in this case are discussed.