Cargando…
Acute Pulmonary Embolism Presenting With Angina and a Positive Cardiac Stress Test
Acute pulmonary embolism (PE) is a commonly missed clinical entity. Prompt diagnosis of PE and the initiation of anticoagulation therapy is vital for the reduction of patient mortality. Recognizing initial electrocardiogram manifestations can aid rapid diagnosis and prompt management. The most commo...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671078/ https://www.ncbi.nlm.nih.gov/pubmed/33214936 http://dx.doi.org/10.7759/cureus.11006 |
_version_ | 1783610857713827840 |
---|---|
author | Waheed, Maham A Khalid, Mazin Hashmi, Arsalan Talib Malyshev, Yury Ayzenberg, Sergey |
author_facet | Waheed, Maham A Khalid, Mazin Hashmi, Arsalan Talib Malyshev, Yury Ayzenberg, Sergey |
author_sort | Waheed, Maham A |
collection | PubMed |
description | Acute pulmonary embolism (PE) is a commonly missed clinical entity. Prompt diagnosis of PE and the initiation of anticoagulation therapy is vital for the reduction of patient mortality. Recognizing initial electrocardiogram manifestations can aid rapid diagnosis and prompt management. The most common EKG findings associated with PE are sinus tachycardia, S1Q3T3 pattern, presence of T wave inversions in V1-V3 associated with the presence of right ventricular (RV) dysfunction, and right bundle branch block. These findings, while specific, are modestly sensitive and not always present. The gold standard of diagnosis is computerized tomographic angiography and ventilation and perfusion (V/Q). Here we present a patient who presented with symptoms mimicking angina with EKG changes in his stress test, prompting coronary angiography, which showed obstructive coronary artery disease requiring revascularization. Subsequently, further evaluation revealed a saddle pulmonary embolism that necessitated pulmonary thrombectomy. |
format | Online Article Text |
id | pubmed-7671078 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-76710782020-11-18 Acute Pulmonary Embolism Presenting With Angina and a Positive Cardiac Stress Test Waheed, Maham A Khalid, Mazin Hashmi, Arsalan Talib Malyshev, Yury Ayzenberg, Sergey Cureus Cardiology Acute pulmonary embolism (PE) is a commonly missed clinical entity. Prompt diagnosis of PE and the initiation of anticoagulation therapy is vital for the reduction of patient mortality. Recognizing initial electrocardiogram manifestations can aid rapid diagnosis and prompt management. The most common EKG findings associated with PE are sinus tachycardia, S1Q3T3 pattern, presence of T wave inversions in V1-V3 associated with the presence of right ventricular (RV) dysfunction, and right bundle branch block. These findings, while specific, are modestly sensitive and not always present. The gold standard of diagnosis is computerized tomographic angiography and ventilation and perfusion (V/Q). Here we present a patient who presented with symptoms mimicking angina with EKG changes in his stress test, prompting coronary angiography, which showed obstructive coronary artery disease requiring revascularization. Subsequently, further evaluation revealed a saddle pulmonary embolism that necessitated pulmonary thrombectomy. Cureus 2020-10-17 /pmc/articles/PMC7671078/ /pubmed/33214936 http://dx.doi.org/10.7759/cureus.11006 Text en Copyright © 2020, Waheed et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Cardiology Waheed, Maham A Khalid, Mazin Hashmi, Arsalan Talib Malyshev, Yury Ayzenberg, Sergey Acute Pulmonary Embolism Presenting With Angina and a Positive Cardiac Stress Test |
title | Acute Pulmonary Embolism Presenting With Angina and a Positive Cardiac Stress Test |
title_full | Acute Pulmonary Embolism Presenting With Angina and a Positive Cardiac Stress Test |
title_fullStr | Acute Pulmonary Embolism Presenting With Angina and a Positive Cardiac Stress Test |
title_full_unstemmed | Acute Pulmonary Embolism Presenting With Angina and a Positive Cardiac Stress Test |
title_short | Acute Pulmonary Embolism Presenting With Angina and a Positive Cardiac Stress Test |
title_sort | acute pulmonary embolism presenting with angina and a positive cardiac stress test |
topic | Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671078/ https://www.ncbi.nlm.nih.gov/pubmed/33214936 http://dx.doi.org/10.7759/cureus.11006 |
work_keys_str_mv | AT waheedmahama acutepulmonaryembolismpresentingwithanginaandapositivecardiacstresstest AT khalidmazin acutepulmonaryembolismpresentingwithanginaandapositivecardiacstresstest AT hashmiarsalantalib acutepulmonaryembolismpresentingwithanginaandapositivecardiacstresstest AT malyshevyury acutepulmonaryembolismpresentingwithanginaandapositivecardiacstresstest AT ayzenbergsergey acutepulmonaryembolismpresentingwithanginaandapositivecardiacstresstest |