Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

27 May 2019 : Case report  USA

Acute Pulmonary Embolism Presenting with Symptomatic Bradycardia: A Case Report and Review of the Literature

Challenging differential diagnosis

Rabah Alreshq1ABCEFG*, Gregory Hsu1EFG, Mikhail Torosoff2ACDEF

DOI: 10.12659/AJCR.915609

Am J Case Rep 2019; 20:748-752

Abstract

BACKGROUND: Acute pulmonary embolism (PE) is a common life-threatening cardiovascular emergency. The diagnosis of PE may be challenging, as there can be a wide range of atypical presentations.

CASE REPORT: A 92-year-old man with asymptomatic first-degree atrioventricular (AV) block, hypertension that was controlled on medication, and a past medical history of deep venous thrombosis (DVT), presented with dizziness, weakness, and collapse while getting dressed. On examination by the attending paramedics, he was noted to have sinus bradycardia at a rate of 18 bpm, which improved to 80 bpm after intravenous injection of atropine. An echocardiogram obtained in the emergency room (ER) showed a markedly dilated right ventricle (RV) with a hypokinetic RV free wall, preserved RV apical contractility, and septal wall motion abnormalities consistent with RV pressure overload. A ventilation/perfusion (V/Q) scan showed a massive PE involving more than 50% of the pulmonary vasculature. Urgent catheter-directed thrombolysis was performed, but the patient’s condition deteriorated, and he died shortly afterward.

CONCLUSIONS: Sinus bradycardia is an unusual initial presentation of PE, but the diagnosis should be considered in patients with multiple risk factors for thromboembolism.

Keywords: Bradycardia, Pulmonary Embolism, thromboembolism, Aged, 80 and over, Fatal Outcome

Add Comment 0 Comments

3844 75

In Press

05 Dec 2023 : Case report  Italy

Novel Mini-Invasive Surgical Technique for Treating Fifth Metacarpal Neck Fractures: A Case Report

Am J Case Rep In Press; DOI:  

01 Dec 2023 : Case report  Brazil

Life-Threatening Electrical Storm Following Liver Transplantation: A Case Report

Am J Case Rep In Press; DOI:  

01 Dec 2023 : Case report  Belgium

Innovative Approach to Difficult Airway Management: Utilizing the Cook® Airway Exchange Catheter for Double...

Am J Case Rep In Press; DOI:  

01 Dec 2023 : Case report  Saudi Arabia

Successful Conservative Therapy for Infected Penile Implants: A Case Series

Am J Case Rep In Press; DOI:  

Most Viewed Current Articles

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

07 Dec 2021 : Case report  USA

Edwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...

DOI :10.12659/AJCR.934347

Am J Case Rep 2021; 22:e934347

19 Jul 2022 : Case report  Saudi Arabia

Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19

DOI :10.12659/AJCR.936128

Am J Case Rep 2022; 23:e936128

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923