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Related Experiment Videos

Pulmonary embolism presenting as syncope in paraplegia: a case report

S Y Chen1, Y H Wang, J J Hwang

  • 1Department of Physical Medicine & Rehabilitation, Taiwan University Hospital, Taipei.

Archives of Physical Medicine and Rehabilitation
|April 1, 1995
PubMed
Summary

Pulmonary embolism is rarely the first sign of syncope. Doctors should suspect pulmonary embolism in high-risk spinal cord injury patients experiencing new symptoms.

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Area of Science:

  • Medicine
  • Cardiology
  • Pulmonology

Background:

  • Syncope is an uncommon initial presentation of pulmonary embolism.
  • Spinal cord injury (SCI) patients are at increased risk for venous thromboembolism.
  • Pulmonary embolism (PE) can occur in patients with SCI, even after stabilization.

Observation:

  • A 16-year-old female with T7 paraplegia post-traumatic SCI presented with syncope.
  • The syncope episode occurred on the 33rd hospital day, 3 hours after tilting table training and passive range-of-motion exercises.
  • This case highlights an unusual presentation of PE in a high-risk patient.

Findings:

  • Diagnostic studies confirmed pulmonary embolism in the left lower pulmonary artery and the lingual lobe.
  • The patient's immobility and recent physical exertion likely contributed to the PE event.

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  • This case underscores the importance of considering PE in SCI patients with new-onset symptoms.

    • Implications:

    • Physicians must maintain a high index of suspicion for PE in SCI patients.
    • Early diagnosis and management of PE are crucial in this vulnerable population.
    • This case emphasizes the need for vigilance regarding thromboembolic events in SCI patients, particularly after physical rehabilitation or changes in activity.