A 38 year old woman came with complaints of breathlessness and swelling over both legs since 15 days
Ultrasonography of the upper abdomen shows dilatation of all three hepatic veins with increased pulsatility and exaggerated ‘a’ wave, diminished ‘s’ wave which is shorter than the ‘d’ wave
CT pulmonary angiography shows a filling defect in the left main pulmonary artery just distal to its origin with 40-50% lumen occlusion