Facharzt FMH Radiologie Practice Questions - Facharzt FMH Für Radiologie Spécialiste FMH En Radiologie Exam

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A 54-year-old woman presents to the emergency department with acute pleuritic chest pain, tachycardia (115 bpm), and hypoxemia. Computed tomography pulmonary angiography (CTPA) confirms acute bilateral pulmonary emboli in the main pulmonary arteries. On the axial 4-chamber reconstructed views, the right ventricular (RV) internal diameter measures 48 mm, while the left ventricular (LV) internal diameter measures 36 mm. Contrast reflux into the inferior vena cava and flattening of the interventricular septum are also noted. What is the clinical significance of these CTPA findings?

These findings are non-specific and indicate chronic pulmonary hypertension rather than acute hemodynamic compromise They represent acute right ventricular strain (RV/LV ratio > 1.0), which stratifies the patient into an intermediate- or high-risk category for adverse clinical outcomes They confirm left-sided diastolic heart failure secondary to systemic fluid overload They indicate an acute patent foramen ovale (PFO) shunt requiring urgent surgical intervention

Correct Answer:

They represent acute right ventricular strain (RV/LV ratio > 1.0), which stratifies the patient into an intermediate- or high-risk category for adverse clinical outcomes

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