Atypical Presentation of Massive Pulmonary Embolism, a Case Report
Archives of Academic Emergency Medicine,
Vol. 2 No. 1 (2014),
1 February 2014
,
Page 46-47
https://doi.org/10.22037/aaem.v2i1.24
Abstract
The lack of pathognomonic signs and symptoms makes the diagnosis of pulmonary embolism (PE) difficult. Here, we report a case of a 42-year-old man presented to the emergency department with worsening epigastric pain, hypotension, frank bradycardia, and final diagnosis of PE. Although previous studies have indicated that abdominal pain was observed in 6.7% of patients with PE, the exact reason for abdominal pain in PE still remains unknown. Tension on the sensory nerve endings, hepatic congestion, and distention of Gilson’s capsule are some of the possible mechanisms of abdominal pain in PE. We conclude that emergency physicians should pay more attention to PE, which is an important differential diagnosis of shock state. In this context, rapid ultrasound in shock (RUSH) should be considered as a vital sign that needs to be evaluated when recording the history of patients presented to the emergency department with signs and symptoms of shock.- Pulmonary embolism
- ultrasonography
- shock
- abdominal pain
- bradycardia
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References
Gantner J, Keffeler JE, Derr C. Pulmonary embolism: An abdominal pain masquerader. J Emerg Trauma Shock. 2013;6 (4):280-2.
Stein PD, Beemath A, Matta F, et al. Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II. Am J Med. 2007;120(10):871-9.
Courtney DM, Kline JA. Identification of prearrest clinical factors associated with outpatient fatal pulmonary embolism. Acad Emerg Med. 2001;8(12):1136-42.
Stein PD, Terrin ML, Hales CA, et al. Clinical, laboratory, roentgenographic, and electrocardiographic findings in pati-ents with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. CHEST Journal. 1991;100 (3):598-603.
Arthur W, Kaye G. The pathophysiology of common causes of syncope. Postgrad Med J. 2000;76(902):750-3.
Ehret GB, Desmeules JA, Broers B. Methadone-associated long QT syndrome: improving pharmacotherapy for dependence on illegal opioids and lessons learned for pharm-acology. Expert Opin on Drug Saf. 2007;6(3):289-303.
Perera P, Mailhot T, Riley D, Mandavia D. The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. Emerg Med Clin North Am. 2010;28(1):29-56.
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