Pulmonary embolism (PE) diagnosed in a 19-year-old lady found to have underlying Antiphospholipid syndrome (APS)

Abstract

ABSTRACT Background A 19-year-old woman visited a family medicine clinic to obtain her laboratory test results. This case highlights a close call involving a young woman with a potentially serious condition. Pulmonary embolism (PE) is often overlooked during initial assessments in emergency departments or primary care clinics. Case presentation The patient casually mentioned having a cough toward the end of the consultation, revealing she has been using a salbutamol inhaler due to a family history of asthma. Despite appearing well, she had an audible wheezy cough during the examination. Following a chest X-ray (CXR) that indicated a right lung opacity and possible cardiomegaly, an electrocardiogram (ECG) was arranged. The ECG showed an incomplete right bundle branch block (RBBB) and STT changes in leads V3-V6 and lead 3, prompting her transfer to the emergency department for suspected Pulmonary embolism (PE). Further evaluation confirmed acute on chronic PE, with a positive lupus screen leading to the diagnosis of antiphospholipid syndrome (APS) upon detection of anti-phospholipid antibodies in her serology. Discussion The patient’s case was unique, but a basic CXR was performed to investigate their exertional shortness of breath. This led to appropriate action being taken to ensure the patient’s safety. It is important to note that pulmonary embolism can occur in young individuals, highlighting the need for attentive and skilled healthcare professionals. Basic tests such as CXR and ECG can be crucial in cases of ongoing symptoms where uncertainty exists.