A 25-year-old woman presented with severe dyspnoea at an emergency care unit on her postpartum day 7. Her O2 saturation level was low. Blood tests showed a high blood D-dimer level; echocardiography showed a high pulmonary artery pressure. Initially, heparin was administered for suspicion of pulmonary embolism. After transfer to the intensive care unit, she suffered respiratory failure. A three-dimensional (3D) reconstruction CT angiography then revealed a giant patent ductus arteriosus. Extracorporeal membrane oxygenation was performed owing to low O2 saturation after ventilator use. After 1 month, she died of multiple organ failure. In postpartum patients with congenital heart disease, a diagnosis of pulmonary embolism should be immediately confirmed by 3D reconstruction CT angiography to rule out patent ductus arteriosus.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645898PMC
http://dx.doi.org/10.1136/bcr-2012-007717DOI Listing

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