Massive pulmonary embolism with extreme hypoxia and hypocarbia caused by knee bandage in young male

Abstract

SummaryPulmonary embolism (PE) caused by obstruction of the pulmonary arterial bed is an acute, life threatening, cardiovascular emergent situation. It is a reversible cause of right ventricular failure. The initial diagnosis majority may be missed due to symptoms and signs are nonspecific. Because of late detection of diagnosis is fatal, PE should be thought when acute dyspnea occurs. PE and deep vein thrombosis (DVT) are clinical situations related to venous thromboembolism (VTE). PE accompanies 50% to DVT. (1) The real incidence of DVT and PE is not known due to nonspecific clinical situation. Pulmonary embolism occurs in 0.4% of hospitalized patients. (2) Keywords: Pulmonary embolism, deep vein thrombosis, ventricular failure. CaseA 34 years old professional basketball player was admitted to our emergency service with ambulance service due to acute dyspnea. The dyspnea had started suddenly after basketball training and the general condition of the patient has rapidly deteriorated. The patient had an injury of left knee anterior cruciate ligament two month ago. A knee bandage had been advised by an orthopedist. Except this injury there was no special characteristic on his background. On physical examination, he was unconscious and extremely cyanotic. He had severe dyspnea and tachypnea. First and second heart sound were normal, but there was right ventricular third heart sound (S3) and jugular venous distention. The blood pressure was 80/50 mmHg. The ECG