Pulmonary embolism presented by syncope in a low-risk patient: a case report

Abstract

Introduction: Pulmonary embolism, an emergency that can have fatal consequences, can be presented with a common symptom that can be missed, such as syncope.Case presentation: We present a case of a young, low-risk male who presented with attacks of syncope and dyspnea followed by massive pulmonary embolism. We also review the pathophysiology of syncope in pulmonary embolism cases and strategy of how to work up with similar cases.Conclusion: Pulmonary embolism should be considered and excluded in every case of recurrent attacks of syncope.

Pulmonary Embolism presenting as Syncope

“…4.5.6 Syncope is infrequent, but may occur regardless of the presence of haemodynamic instability.7 In more severe cases, cyanosis, syncope and circulatory instability occur, and sometimes peripheral edema may be present. 8 Syncope in the setting of pulmonary embolism can be the result of three possible mechanisms. First, greater than 50% occlusion of the pulmonary vascular tree causes right ventricular failure and impaired left ventricular filling, leading to a reduction in cardiac output, arterial hypotension, reduced cerebral blood flow, and ultimately syncope.…”