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Massive pulmonary embolism presenting as seizures.

Shahrukh Hashmani1, Fateh Ali Tipoo Sultan2, Murtaza Kazmi3

  • 1Cardiology Resident Year II, Department of Medicine, AKUH, Karachi.

JPMA. the Journal of the Pakistan Medical Association
|February 10, 2017
PubMed
Summary

Massive pulmonary embolism (MPE) is rarely linked to seizures. This case highlights MPE as a cause of seizures, chest pain, and low blood pressure in trauma patients, managed successfully with thrombolysis.

Keywords:
Case report, Massive pulmonary embolism, Seizure, Emergent thrombolysis, Chest pain.

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Area of Science:

  • Cardiology
  • Neurology
  • Trauma Medicine

Background:

  • Pulmonary embolism (PE) can manifest unusually.
  • Seizure activity is a rare presenting symptom of PE.
  • Trauma patients are at risk for thromboembolic events.

Purpose of the Study:

  • To report a rare case of massive pulmonary embolism presenting with seizures.
  • To highlight the importance of considering PE in patients with unexplained seizures and hemodynamic instability post-trauma.

Main Methods:

  • Case report of a 38-year-old male trauma patient.
  • Diagnostic workup included CT pulmonary angiography (CTPA), ECG, and echocardiogram.
  • Treatment involved thrombolysis.

Main Results:

  • Patient presented with seizures, chest pain, shortness of breath, and hypotension one month post-road traffic accident and surgery.
  • CTPA confirmed massive pulmonary embolism with characteristic ECG and echocardiogram findings.
  • Successful management with thrombolysis was achieved.

Conclusions:

  • Massive pulmonary embolism should be considered in the differential diagnosis of seizures, especially in patients with hemodynamic compromise.
  • Prompt diagnosis and management, including thrombolysis, can lead to favorable outcomes in massive PE.
  • This case underscores the diverse clinical presentations of PE and its potential neurological sequelae.