Think Beyond the Obvious: Atypical Pulmonary Embolism Presentation in a Parkinson's Disease Patient

Pulmonary embolism (PE), a potentially life-threatening condition, results from obstruction of the pulmonary arteries by thromboemboli. It typically presents with cough, dyspnea, pleuritic-type chest pain, hemoptysis, or hemodynamic instability. However, in patients with Parkinson's disease (PD) or elderly patients, it may present with recurrent falls. Falls as a primary presenting symptom of PE are rare and underrecognized but should be considered in patients with PD, especially if the falls are new-onset, unexplained, or associated with signs of hemodynamic compromise. We report a case of an elderly patient with PD whose recent unexplained falls led to the diagnosis of PE, emphasizing the need for heightened clinical suspicion in this patient population, especially when presenting with unexplained falls in the emergency department. Missed diagnosis of PE can potentially lead to serious long-term morbidity and mortality.