Rama Sapna, Fonarov Ilya, Casadesus Damian
Primary Care, Orlando College of Osteopathic Medicine, Orlando, USA.
Hospital Medicine, Jackson Memorial Hospital, Miami, USA.
Cureus. 2024 Jul 17;16(7):e64751. doi: 10.7759/cureus.64751. eCollection 2024 Jul.
Pulmonary embolism (PE) is a life-threatening disease with variable clinical signs and symptoms, and the diagnosis often requires a high index of suspicion. Patients can have a variety of risk factors that predispose them to venous thromboembolic (VTE) disease. This is a case of a female who presented to the emergency room with new-onset fatigue and shortness of breath for five days. The patient was diagnosed with a sub-massive PE with high-risk features. The patient was also hyperglycemic and diagnosed with new-onset diabetes mellitus. For the PE, she was treated with systemic thrombolysis followed by a standard oral factor Xa inhibitor; for her new onset of diabetes, the patient was started on glargine and lispro insulin. This case underscores the importance of comprehensive management for patients with PE and concurrent metabolic conditions.
肺栓塞(PE)是一种具有多种临床体征和症状的危及生命的疾病,其诊断通常需要高度的怀疑指数。患者可能有多种易患静脉血栓栓塞(VTE)疾病的危险因素。这是一例女性患者,因新发疲劳和气短5天就诊于急诊室。该患者被诊断为具有高危特征的次大面积肺栓塞。患者还存在高血糖,并被诊断为新发糖尿病。对于肺栓塞,她接受了全身溶栓治疗,随后使用标准口服Xa因子抑制剂;对于新发糖尿病,患者开始使用甘精胰岛素和赖脯胰岛素治疗。该病例强调了对合并代谢性疾病的肺栓塞患者进行综合管理的重要性。