Interventricular septal shift due to massive pulmonary embolism shown by CT pulmonary angiography: an old sign revisited

The computed tomographic (CT) pulmonary angiogram appearances of acute righ t ventricular dysfunction due to massive pulmonary embolus in a patient are described. Abnormal findings comprised right ventricular dilatation, inter ventricular septal shift, and compression of the left ventricle. These chan ges resolved following thrombolysis. Use of CT pulmonary angiography to dia gnose pulmonary emboli is increasing. Secondary cardiac effects are establi shed diagnostic features shown by echocardiography. These have not been pre viously described but are important to recognise as they may carry importan t prognostic and therapeutic implications.