Pulmonary embolism simulating non-ST segment elevation acute coronary syndrome

Authors

  • Alain Alonso Herrera
  • Mario E. Nápoles Lizano
  • Rafael A. Ibáñez Azán
  • Arnaldo Rodríguez Leon

Abstract

Pulmonary embolism takes place as a consequence of the migration of a thrombus towards the pulmonary vascular tree. Patients frequently report chest pain that can mimic an acute coronary syndrome. We present the case of a 57-year-old patient who came to the emergency department with acute chest pain and dyspnea. He was diagnosed as a non-ST segment elevation acute coronary syndrome, due to the electrocardiographic changes that he presented at admission, but the echocardiographic findings showed increased pulmonary pressures, and the invasive coronary angiography, normal coronary arteries; therefore, a pulmonary angiography with multislice tomography was performed, which confirmed the diagnosis of bilateral pulmonary embolism.

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References

1. Parra Gordo ML. Tromboembolismo pulmonar: estudio de tomografía computarizada pulmonar. Análisis de hallazgos y factores pronósticos. [Tesis de Doctorado]. Madrid: Hospital Universitario La Princesa [Internet]; 2016 [citado 7 Dic 2020]. Disponible en: https://repositorio.uam.es/bitstream/handle/10486/679012/parra_gordo_mariluz.pdf?sequence=1

2. Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J. 2014;35(43):3033-69. DOI: https://doi.org/10.1093/eurheartj/ehu283

3. Sinha N, Yalamanchili K, Sukhija R, Aronow WS, Fleisher AG, Maguire GP, et al. Role of the 12-lead electrocardiogram in diagnosing pulmonary embolism. Cardiol Rev. 2005;13(1):46-9. DOI: https://doi.org/10.1097/01.crd.0000134647.55135.4a

4. Beckman MG, Hooper WC, Critchley SE, Ortel TL. Venous thromboembolism: a public health concern. Am J Prev Med. 2010;38(Suppl 4):S495-501. DOI: https://doi.org/10.1016/j.amepre.2009.12.017

5. Özer N, Yorgun H, Canpolat U, Ateş AH, Aksöyek S. Pulmonary embolism presenting with evolving electrocardiographic abnormalities mimicking anteroseptal myocardial infarction: a case report. Med Princ Pract. 2011;20(6):577-80. DOI: https://doi.org/10.1159/000330030

6. Siddiqa A, Haider A, Jog A, Yue B, Krim NR. Pulmonary Embolism Presenting as ST-Elevation Myocardial Infarction: A Diagnostic Trap. Am J Case Rep [Internet]. 2020 [citado 10 Dic 2020];21:e927923. Disponible en: https://doi.org/10.12659/ajcr.927923

7. Villablanca PA, Vlismas PP, Aleksandrovich T, Omondi A, Gupta T, Briceno DF, et al. Case report and systematic review of pulmonary embolism mimicking ST-elevation myocardial infarction. Vascular. 2019;27(1):90-7. DOI: https://doi.org/10.1177/1708538118791917

8. Carrier M, Righini M, Wells PS, Perrier A, Anderson DR, Rodger MA, et al. Subsegmental pulmonary embolism diagnosed by computed tomography: incidence and clinical implications. A systematic review and meta-analysis of the management outcome studies. J Thromb Haemost. 2010;8(8):1716-22. DOI: https://doi.org/10.1111/j.1538-7836.2010.03938.x

9. Stein PD, Fowler SE, Goodman LR, Gottschalk A, Hales CA, Hull RD, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med. 2006;354(22):2317-27. DOI: https://doi.org/10.1056/nejmoa052367

10. Zelfani S, Manai H, Laabidi S, Wahabi A, Akeri S, Daghfous M. Pulmonary embolism mimicking acute myocardial infarction: a case report and review of literature. Pan Afr Med J [Internet]. 2019 [citado 17 Dic 2020];33:275. Disponible en: https://doi.org/10.11604/pamj.2019.33.275.18517

11. Hernández Navas M, Pérez Barreda A, Selman-Housein Bernal K, Obregón Santos A, Quevedo Benítez A, de Zayas Galguera J. Tromboembolismo pulmonar o infarto de ventrículo derecho: Dilema clínico, a propósito de un caso. CorSalud [Internet]. 2015 [citado 17 Dic 2020];7(3):243-7. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/66

Published

2021-07-12

How to Cite

1.
Alonso Herrera A, Nápoles Lizano ME, Ibáñez Azán RA, Rodríguez Leon A. Pulmonary embolism simulating non-ST segment elevation acute coronary syndrome. CorSalud [Internet]. 2021 Jul. 12 [cited 2025 Jun. 24];13(3):381-5. Available from: https://revcorsalud.sld.cu/index.php/cors/article/view/858

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Section

CASE REPORTS