Pulmonary Embolism Mimicking Acute Severe Asthma

Area of Science:

• Pulmonology
• Emergency Medicine
• Cardiology

Background:

• Wheezing is a common respiratory symptom often associated with asthma.
• Pulmonary embolism (PE) is typically characterized by dyspnea and chest pain, with wheezing being an uncommon presentation.
• Sub-massive PE requires prompt diagnosis and management to prevent adverse outcomes.

Observation:

• A patient presented with severe wheezing, initially diagnosed and treated as acute severe asthma.
• The patient had no prior history of cardiovascular or pulmonary diseases.
• Despite aggressive asthma treatment, the patient showed a poor response.

Findings:

• The patient was diagnosed with sub-massive pulmonary embolism.
• Bronchoconstriction caused by PE was the underlying mechanism for the wheezing.
• Pulmonary embolism can present atypically, mimicking acute severe asthma.

Implications:

• Clinicians should consider pulmonary embolism in the differential diagnosis of patients presenting with severe wheezing, especially those unresponsive to asthma treatment.
• This case underscores the importance of a high index of suspicion for PE in atypical presentations.
• Early and accurate diagnosis of PE is crucial for effective management and improved patient outcomes.