A Rare Presentation of Pulmonary Thromboembolism as Seizure

Abstract

Acute pulmonary thromboembolism is a critical and sometimes fatal event that is difficult for clinicians to diagnose because of its various initial manifestations. Here, we report a previously healthy 50-year-old man without any history of seizures who presented to the emergency ward with the new-onset seizure. Neurology consult was performed, but found no focal neurological deficits. The diagnosis of massive pulmonary embolism was confirmed by echocardiography and pulmonary CT angiography. Alteplase and heparin with therapeutic dosage were started for the patient. After initiating treatment, patient’s dyspnea, arterial O2 saturation, and general condition were significantly improved. Echocardiography was repeated and showed a smaller right ventricle size and lower pulmonary artery pressure than the first echocardiography.

A 68-Year-Old Man Presenting to the ER with Sudden Dyspnea, A Rare Case of Snowstorm View in the Right Ventricle during Echocardiography

“…Pulmonary Thromboembolism (PTE) is the third leading cause of cardiovascular death worldwide [1]. Smoking cigarettes, malignancies, obesity, age, heredity, prolonged comorbidities, and surgical history are known risk factors for PTE [2,3].…”

“…Smoking cigarettes, malignancies, obesity, age, heredity, prolonged comorbidities, and surgical history are known risk factors for PTE [2,3]. PTE can present with common symptoms that can be misdiagnosed as other critical or non-critical diseases [1,4]. Some of the symptoms includerespiratory distress, chest pain, presyncopeor syncope, and bloody sputum [2,5,6].…”