The Variability in the Clinical Presentation of Acute Pulmonary Embolism: A Case Series
Keywords:
Deep venous thrombosis, D-dimer, multi-detector computed tomography pulmonary angiography, MD-CTPA, Pulmonary embolism, PEAbstract
Background: Acute pulmonary embolism (PE) occurs when a thrombus dislodges from a peripheral part of the body to block any of the branches of the pulmonary artery. Depending on the size of the embolus and the underlying disease state, its presentation can range from being asymptomatic to presenting with sudden death. Its variable nature of presentation frequently leads to a missed diagnosis and increased morbidity or mortality from PE. This series aims to highlight some of the variable presentations of acute pulmonary embolism with the objective of stimulating a high index of suspicion, which can lead to early diagnosis and treatment.
Method: The electronic medical records of 3 patients in a private hospital in Abuja were selected for the series, together with a review of the existing literature. Consent to use patient information was obtained from the patients, and the approval for the case series obtained from the head of the department of research of the hospital.
Result: The clinical presentation of acute PE was highly variable in all 3 cases, with the least symptomatic case having a saddle-embolus lodged at the bifurcation of the pulmonary artery. Electrocardiographic tracings were also different in all 3 cases.
Conclusion: The prognosis of PE depends on early diagnosis and treatment. Mortality and morbidity from this condition can be reduced with a background knowledge of its variable clinical presentation and a high-index of suspicion.
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