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.