In the lateral view chest x-ray, there is a Hampton’s Hump, a pleural based, wedge-shaped opacity at the base of the right lung, representing lung infarction (black arrow). These findings correlate with the sagittal view on CT angiography of the chest. The CT chest also shows a filling defect in the distal posterior basal segmental pulmonary artery (white arrow), as demonstrated by the absence of contrast enhancement in the distal portion of the vessel. This is associated with an opacification of the lung parenchyma distal to the occlusion (red arrow), representing lung infarction.
The ECG shows diffuse ST- elevation. The patient also has mild PR-depression, most notably in the inferior and lateral leads. The patient also has minimal PR elevation in lead aVR. The patient was diagnosed with acute pericarditis (ECG stage 1).
The left Achilles tendon had a defect on palpation, while the right Achilles tendon was intact. When squeezing the right (unaffected) calf, the ankle spontaneously plantar flexed, indicating a negative (normal) Thompson test. Upon squeeze of the left (affected) calf, the ankle did not plantar flex, signifying a positive (abnormal) Thompson test. The diagnosis of left Achilles tendon rupture was confirmed intraoperatively one week later.