A 35-year-old male with history of 4 weeks of immobilization for fracture of femur develops sudden onset breathlessness and blood in sputum. CT angiography shows?

a. Acute cor-pulmonale
b. Pulmonary oedema
c. Aortic dissection
d. Fat embolism

Ans. (a) Acute cor-pulmonale

The CT chest shows an embolus at bifurcation of pulmonary artery. The clinical history of immobilization points to etiology as Deep vein thrombosis. Hence the
diagnosis is pulmonary embolism. This leads to acute onset RVF due to non-cardiogenic cause and is called acute cor-pulmonale.

‘The resultant pulmonary oligaemia explains the breathlessness. The sudden increase in pulmonary artery pressure explains the blood in sputum.

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