Abstract
A 24-year-old male was presented to us with sudden onset of chest pain and dyspnea for the past one hour. There was no history of calf pain, trauma, surgery, prolonged immobilization, long-haul air travel, bleeding diathesis or any other co-morbidity. The patient denied any addiction history. The Electrocardiogram showed tachycardia with S1Q3T3 pattern. The left arterio-venous Doppler study was suggestive of a thrombus in popliteal vein and sapheno-popliteal junction. The CT-Pulmonary Angiogram scan was suggestive of a massive pulmonary thromboembolism. The patient was thrombolysed with Intravenous Alteplase immediately and was put on tab Rivaroxaban for maintenance. He was later discharged after being stable. Unprovoked venous thromboembolism (VTE) is very rare and has the potential to lead to pulmonary embolism which could be disastrous, especially in young adults. We present such a case where unprovoked VTE was diagnosed and treated. This case suggests that high clinical suspicion is the key for the diagnosis of acute pulmonary embolism, especially in the absence of history suggestive of deep vein thrombosis.
Highlights
Venous thromboembolism (VTE) consists of pulmonary embolism (PE) and deep vein thrombosis (DVT)
The patient developed hypotension which was treated with inotropic support. He had tachycardia post-thrombolysis for the two days, his blood pressure returned to normal on the third day. 48-hours after giving thrombolytic treatment, the left lower limb venous doppler was done which was suggestive of a partial-lumen occluding the thrombus in popliteal vein extending from saphenopopliteal junction to mid-leg approximately 10 cm long
The most common and important ECG finding in a patient with PE is sinus tachycardia and the presence of S1Q3T3 pattern in the ECG. Presence of these findings shortened the time for diagnosis of acute PE in our patient and the management after that[4]
Summary
Case report Authors may add the time when the patient was brought to the hospital, along with the nature of his works in previous 12 hours, if the information is available. What was the rhythm of the pulse in clinical examination? If the data is available, the authors may add it What was the rhythm of the pulse in clinical examination? If the data is available, the authors may add it
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