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CT SCAN OF CHEST WITH CONTRAST

HISTORY: This is a 52-year-old female with worsening shortness of breath and lower extremity edema.  Patient has a history of congestive heart failure, hypertension, and COPD. 
 
TECHNIQUE: CT chest angiogram, PE protocol, with lower extremity runoffs was performed with administration of 120 ml omnipaque 350.
 
COMPARISON: Chest radiographs dating back to March 2006 
 
FINDINGS: No main or segmental pulmonary embolism. Limited evaluation of the lower extremity veins due to suboptimal opacification of the veins.  However, no gross evidence of a filling defect within the lower extremity veins.
 
Status post CABG. There is moderate cardiomegaly without pericardial effusion.  There is reflux of contrast into the IVC and hepatic veins suggestive of tricuspid regurgitation versus right-sided heart failure. No ground glass opacities or pleural effusion.  Small 8 mm prevascular lymph nodes are demonstrated.  There is no significant axillary, hilar or other mediastinal adenopathy.
 
Lungs are clear. Thoracic cage is intact.  Incidentally noted is a fibroid uterus.  

IMPRESSION:
1.  No main or segmental pulmonary embolism.  No gross evidence of bilateral lower extremity DVT.
2. Cardiomegaly with reflux of contrast into the IVC and hepatic veins, suggestive of tricuspid regurgitation or right heart failure.
3. Fibroid uterus.