Chronic pulmonary embolism with right ventricular strain

A large filling defect involving the left pulmonary artery along the entire course from the level of its origin extending to the upper as well as lower lobar branches with complete lack of opacification of the distal lobar and segmental branches of the left pulmonary artery forming 90° angulation with the vessel wall – suggestive of large chronic thrombosis.

Dilated main pulmonary artery, measuring 3.4 cm in maximum diameter.

Mild thickening of walls of the distal part of right main pulmonary artery and the lower lobar branch associated with tiny filling defects within the lumen of lower lobar branches and segmental branches of the right pulmonary artery – suggestive of chronic right pulmonary embolism.

An approximately 3 x 1.6 cm thick walled subpleural pulmonary cavitation in posterior basal segment of left lower lobe – likely related to a sequelae of focal pulmonary infarct.

Cardiomegaly .

Straightening of the interventricular septum which may suggest right ventricular strain.