Massive pulmonary embolism presenting initially as acute psychosis

Area of Science:

• Cardiology
• Neurology
• Psychiatry

Background:

• Parkinson's disease (PD) patients may exhibit neuropsychiatric symptoms.
• Acute psychosis is a less common presentation in PD patients.

Observation:

• A 68-year-old male with PD presented with new-onset aggression and hallucinations.
• He developed sudden dyspnea, cardiac arrest, and was diagnosed with a saddle pulmonary embolism.

Findings:

• Systemic thrombolysis for pulmonary embolism improved the patient's hemodynamic status.
• Psychotic symptoms resolved following treatment for pulmonary embolism.

Implications:

• Pulmonary embolism should be considered in the differential diagnosis of new-onset psychosis in PD patients.
• Early detection and management of pulmonary embolism can lead to resolution of psychiatric manifestations.