Case 1
A 17 -year-old Caucasian female (BMI 34.09 kg/m2)
presented with acute right sided chest pain and shortness of breath.
Computed tomography angiography (CTA) of the chest revealed bilateral
pulmonary embolism (PE) (Figure 1). Ultrasound Doppler evaluation of the
lower extremities did not show any evidence of a DVT. Echocardiogram
evaluation did not show evidence of cor pulmonale. Risk factors for VTE
were obesity and the use of COC (norgestrel 0.3 mg - ethinyl estradiol
30 mcg) for approximately one year, prescribed to treat dysmenorrhea and
menorrhagia. Thrombophilia evaluation was negative. Repeat chest CTA
after three months of anticoagulation showed resolution of the bilateral
pulmonary embolism.