Acute neurological deficit with submassive pulmonary emboli.
BMJ Case Rep
; 15(3)2022 Mar 15.
Article
in English
| MEDLINE | ID: covidwho-1745764
ABSTRACT
Pulmonary embolism (PE) is frequently encountered in the emergency department. Syncope, often as a consequence of impending haemodynamic collapse, is associated with increased mortality. While loss of consciousness owing to cerebral hypoperfusion and reduced left ventricular preload is a common cause of collapse with large volume PE, other syndromes can also cause neurological deficit in thromboembolic disease. Here, we describe a case of a woman in her 60s, presenting to the emergency department with features of high-risk PE. During clinical examination, the patient collapsed and became unresponsive with a Glasgow Coma Scale of 4/15 despite normal haemodynamics. Neurological signs were noted and CT revealed evidence of a large territory cerebral infarction. Further cardiovascular investigations identified a grade 4 patent foramen ovale. We describe a challenging case of established venous thromboembolism complicated by paradoxical embolism, highlighting the importance of thorough clinical examination and investigation and discuss the current evidence base of treatments.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pulmonary Embolism
/
Embolism, Paradoxical
/
Foramen Ovale, Patent
/
Venous Thromboembolism
Type of study:
Case report
/
Prognostic study
Topics:
Long Covid
Limits:
Female
/
Humans
Language:
English
Year:
2022
Document Type:
Article
Affiliation country:
Bcr-2021-247923
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