Syncope and Dyspnea and Pulmonary Embolism

Area of Science:

• Cardiology
• Pulmonology
• Medical Diagnostics

Background:

• Acute cor pulmonale is a severe condition often presenting with subtle or non-specific symptoms.
• Pulmonary emboli (PE) are a leading cause of preventable death in hospitalized patients.
• Electrocardiogram (ECG) is a readily available diagnostic tool in emergency settings.

Observation:

• A male patient presented with new onset syncope and dyspnea.
• ECG findings suggestive of acute cor pulmonale were not recognized.
• The patient subsequently died due to undiagnosed pulmonary emboli.

Findings:

• Missed ECG diagnosis of acute cor pulmonale contributed to delayed treatment for pulmonary emboli.
• Failure to identify critical cardiac strain secondary to pulmonary hypertension led to a fatal outcome.
• The case highlights the importance of a high index of suspicion for PE in patients with relevant symptoms.

Implications:

• Emphasizes the need for enhanced training in interpreting ECG for acute cor pulmonale.
• Underscores the critical role of timely diagnosis of pulmonary emboli in preventing mortality.
• Suggests integrating advanced cardiac and pulmonary diagnostic protocols for patients with syncope and dyspnea.