患者女,51岁。胸闷1周入院,既往有子宫肌瘤切除及直肠癌根治病史。入院后查体,呼吸28次/min,心率76次/min,血压135/75 mm Hg,左肺呼吸音低,双肺未闻及干湿啰音,心界向右扩大,心律齐,P2亢进,各瓣膜听诊区未闻及病理性杂音。肺动脉CT血管三维成像提示:双肺动脉栓塞。血凝常规:D-二聚体显著升高(5 880.00ng/ml)。下肢血管超声:双侧胫后静脉血栓形成。超声心动图检 Female patient, 51 years old. Chest tightness 1 week admission, previous myomectomy and rectal cancer radical history. After admission, physical examination, breathing 28 beats / min, heart rate 76 beats / min, blood pressure 135/75 mm Hg, left lung breath sounds low, lungs did not smell and wet and dry rales, heart to the right to expand, heart qi, P2 Hypertension, the valve auscultation area has not heard and pathological murmur. Pulmonary arterial CT angiography three-dimensional imaging tips: pulmonary embolism. Blood coagulation routine: D-dimer was significantly elevated (5880.00 ng / ml). Lower extremity vascular ultrasound: bilateral posterior tibial venous thrombosis. Echocardiography