Summary

Chest pain is a common clinical event that overwhelms many patients and is often a sign of coronary ischaemia. The comprehensive influence of pulmonary vein thrombosis (PVT) on coronary artery ischaemia is underappreciated. A 64-slice multidetector CT (64-MDCT) scan can detect pulmonary vein thrombi. A 68-year-old man was referred for the assessment of recent chest pain. A 64-MDCT scan was performed to assess his coronary artery. Although the scan did not show a coronary artery plaque, it did show a thrombus in the right lower pulmonary vein. After 3 months of dabigatran therapy, some parts of the thrombus had dissolved, and the image of the thrombus was more vague. The darkness of the thrombus was lost, indicating that the thrombus had loosened in structure and that the contrast enhancements were able to penetrate into the thrombus. PVT was identified as the likely aetiology for the cause of the chest pain.