Cargando…

Cocaine-Induced Ventilation/Perfusion Mismatch Mimicking Pulmonary Embolism

Pulmonary complications from cocaine use can range from bronchospasm to vasospasm leading to pulmonary infarction. Profound vasospasm may also lead to perfusion defects presenting as pulmonary embolism on ventilation-perfusion scan. A 65-year-old patient with a past medical history of substance abus...

Descripción completa

Detalles Bibliográficos
Autores principales: Surapaneni, Phani Keerthi, Abe, Temidayo, Fas, Norberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025422/
https://www.ncbi.nlm.nih.gov/pubmed/32054344
http://dx.doi.org/10.1177/2324709620906962
_version_ 1783498508738756608
author Surapaneni, Phani Keerthi
Abe, Temidayo
Fas, Norberto
author_facet Surapaneni, Phani Keerthi
Abe, Temidayo
Fas, Norberto
author_sort Surapaneni, Phani Keerthi
collection PubMed
description Pulmonary complications from cocaine use can range from bronchospasm to vasospasm leading to pulmonary infarction. Profound vasospasm may also lead to perfusion defects presenting as pulmonary embolism on ventilation-perfusion scan. A 65-year-old patient with a past medical history of substance abuse and chronic kidney disease presents to the emergency department with sudden-onset chest pain and shortness of breath. Ventilation-perfusion scan revealed filling defect most notably in the lingual lobe. He was later discharged on warfarin for the management of pulmonary embolism. The patient presented to the emergency department 2 weeks later with similar complaints; the international normalized ratio was subtherapeutic, and urine drug screen was positive for cocaine. Repeat ventilation-perfusion scan revealed no filling defects. Follow-up bilateral venous Doppler of lower extremities and D-dimer were within normal limits.
format Online
Article
Text
id pubmed-7025422
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-70254222020-02-27 Cocaine-Induced Ventilation/Perfusion Mismatch Mimicking Pulmonary Embolism Surapaneni, Phani Keerthi Abe, Temidayo Fas, Norberto J Investig Med High Impact Case Rep Case Report Pulmonary complications from cocaine use can range from bronchospasm to vasospasm leading to pulmonary infarction. Profound vasospasm may also lead to perfusion defects presenting as pulmonary embolism on ventilation-perfusion scan. A 65-year-old patient with a past medical history of substance abuse and chronic kidney disease presents to the emergency department with sudden-onset chest pain and shortness of breath. Ventilation-perfusion scan revealed filling defect most notably in the lingual lobe. He was later discharged on warfarin for the management of pulmonary embolism. The patient presented to the emergency department 2 weeks later with similar complaints; the international normalized ratio was subtherapeutic, and urine drug screen was positive for cocaine. Repeat ventilation-perfusion scan revealed no filling defects. Follow-up bilateral venous Doppler of lower extremities and D-dimer were within normal limits. SAGE Publications 2020-02-13 /pmc/articles/PMC7025422/ /pubmed/32054344 http://dx.doi.org/10.1177/2324709620906962 Text en © 2020 American Federation for Medical Research https://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Surapaneni, Phani Keerthi
Abe, Temidayo
Fas, Norberto
Cocaine-Induced Ventilation/Perfusion Mismatch Mimicking Pulmonary Embolism
title Cocaine-Induced Ventilation/Perfusion Mismatch Mimicking Pulmonary Embolism
title_full Cocaine-Induced Ventilation/Perfusion Mismatch Mimicking Pulmonary Embolism
title_fullStr Cocaine-Induced Ventilation/Perfusion Mismatch Mimicking Pulmonary Embolism
title_full_unstemmed Cocaine-Induced Ventilation/Perfusion Mismatch Mimicking Pulmonary Embolism
title_short Cocaine-Induced Ventilation/Perfusion Mismatch Mimicking Pulmonary Embolism
title_sort cocaine-induced ventilation/perfusion mismatch mimicking pulmonary embolism
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025422/
https://www.ncbi.nlm.nih.gov/pubmed/32054344
http://dx.doi.org/10.1177/2324709620906962
work_keys_str_mv AT surapaneniphanikeerthi cocaineinducedventilationperfusionmismatchmimickingpulmonaryembolism
AT abetemidayo cocaineinducedventilationperfusionmismatchmimickingpulmonaryembolism
AT fasnorberto cocaineinducedventilationperfusionmismatchmimickingpulmonaryembolism