Massive Bilateral Pulmonary Thromboembolism – A Bolt from the Blue Case Report

Abstract

Thrombosis originating from the deep veins of the lower limbs can result in recurrent emboli leading to acute on chronic pulmonary thromboembolism. The death in such situations would be sudden and unexpected due to acute right sided heart failure (cor pulmonale). There can be few preceding non-specific symptoms such as cough and/or dyspnoea, especially in non-hospitalised decedents. Many a time pulmonary thromboembolism is only detected in a medicolegal autopsy. The sudden and unexpected death in an apparently healthy individual paves the way for a police inquest procedures, and a medicolegal autopsy would be the only legal and logical alternative to find a closure. However, massive bilateral pulmonary thromboembolism occluding almost more than 80 percentage of the pulmonary artery vasculature is an extremely rare phenomenon in a medicolegal autopsy. This case report has been prepared to discuss on such a rare presentation, discovered during the medicolegal autopsy of an apparently healthy 46-year-old individual who collapsed on the sides of a road, and was brought dead to the hospital.