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59 y/o woman, shortness of breath and chest pain

Presentation

A 59-year-old woman presents to the emergency room with shortness of breath and chest pain on deep inspiration. She has been immobilized for the past two weeks due to fracture of her left foot and ankle. On physical exam, she is dyspneic and tachycardic with a respiratory rate of 22 and a heart rate of 100. Her lungs are clear on auscultation. There is moderate swelling of her left lower extremity. Her oxygen saturation is 93% on room air and her ECG is unremarkable.

Images

AP and lateral plain radiographs of the chest
Perfusion scintigraphy
Ventilation scintigraphy
Repeat perfusion scan 5 days later

Description of Findings

Full case report

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