an unusual presentation of a massive pulmonary embolism with misleading investigation results treated with tenecteplase

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ID: 177013
2015
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Abstract
Background. There is no foolproof strategy to identify a pulmonary embolism (PE) in the emergency department, and atypical presentations are common. Negative test results may mislead physicians away from the diagnosis of PE. Objectives. The current report aims to raise awareness of an unusual presentation of massive PE and its diagnosis and management, in the face of limited evidence in the scientific literature. Case Reports. We report the case of a patient with a negative D-Dimer and a negative Computed Tomography contrast angiography of the chest who was diagnosed twenty-seven hours later with a massive PE, as suggested by a bedside echocardiography. The patient was successfully treated with tenecteplase (TNK). Conclusions/Summary. Pulmonary embolism frequently presents atypically and is often a diagnostic challenge. There is limited literature about the treatment of massive PE. Further research on bedside echocardiography for diagnosing PE in unstable patients is warranted. In addition, further study into new thrombolytic agents like tenecteplase in the context of massive and submassive PE is warranted.
Reference Key
migneault2015casean Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;David Migneault;Zachary Levine;François de Champlain
Journal Ecology letters
Year 2015
DOI
10.1155/2015/868519
URL
http://dx.doi.org/10.1155/2015/868519
Keywords
critical care first aid intensive care medical emergencies

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