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A Porcine Model of Acute Autologous Pulmonary Embolism
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'STEMI-like' acute pulmonary embolism, an unusual presentation
Abuelmagd Abdalla1, Frank Kelly1
1Midland Regional Tullamore, Tullamore, Ireland.
BMJ Case Reports
|November 22, 2014
Summary
A 65-year-old man presented with symptoms mimicking ST elevation myocardial infarction (STEMI) but was diagnosed with pulmonary embolism (PE). Early anticoagulation, crucial for both conditions, led to a full recovery.
Area of Science:
- Cardiology
- Pulmonology
- Emergency Medicine
Background:
- Pulmonary embolism (PE) can present atypically, mimicking other acute cardiovascular events.
- ST elevation myocardial infarction (STEMI) is a critical diagnosis requiring immediate intervention.
Observation:
- A 65-year-old male presented with dyspnea, exhibiting ECG changes consistent with anteroseptal STEMI and elevated troponin.
- Initial diagnosis favored STEMI with left ventricular aneurysm due to ST elevation and Q waves.
- Normal coronary angiography prompted re-evaluation, leading to suspicion of PE.
Findings:
- CT pulmonary angiography confirmed bilateral PE with a large thrombus in the right main pulmonary artery.
- D-dimer levels were elevated.
- The patient recovered well with anticoagulation, and ST elevation resolved.
Implications:
- This case highlights the importance of considering PE in STEMI mimics, especially with normal coronary angiography.
- Prompt anticoagulation is vital for both STEMI and PE, underscoring the need for rapid differential diagnosis.
- Atypical presentations of PE can delay diagnosis but may not compromise outcomes if timely, appropriate treatment is initiated.
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