Ghonem Mohamed, Abdelraouf Islam, Chua Wilsonne
Cardiology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, GBR.
Cardiology, University Hospitals of Leicester NHS Trust, Leicester, GBR.
Cureus. 2024 Dec 26;16(12):e76417. doi: 10.7759/cureus.76417. eCollection 2024 Dec.
Pulmonary embolism (PE) is a life-threatening condition with varied presentations, occasionally mimicking ST-segment elevation myocardial infarction (STEMI). This case highlights a 52-year-old male patient with a history of venous thromboembolism (VTE) who presented with progressive shortness of breath over a month, culminating in dyspnea at rest, and anterior ST-segment elevation on electrocardiography (ECG). The initial evaluation suggested STEMI. Notably, chest pain, a typical feature of STEMI, was absent. This combined with the patient's clinical background and shortness of breath as presenting symptoms prompted further investigation. Bedside echocardiography revealed right ventricular dilation and dysfunction, and computed tomography (CT) pulmonary angiography confirmed massive PE. Despite anticoagulation and mechanical thrombectomy, the patient succumbed to complications before pulmonary endarterectomy. This report underscores the importance of integrating clinical acumen, advanced imaging modalities, and timely multidisciplinary collaboration to avoid misdiagnosis and optimize patient outcomes in critical cases.
肺栓塞（PE）是一种危及生命的疾病，表现多样，偶尔会酷似ST段抬高型心肌梗死（STEMI）。本病例着重介绍了一名52岁男性患者，有静脉血栓栓塞（VTE）病史，在一个多月的时间里逐渐出现气短，最终发展为静息时呼吸困难，心电图（ECG）显示前壁ST段抬高。初步评估提示为STEMI。值得注意的是，STEMI的典型特征胸痛并不存在。这一情况结合患者的临床背景以及作为主要症状的气短促使进行进一步检查。床旁超声心动图显示右心室扩张和功能障碍，计算机断层扫描（CT）肺动脉造影证实为大面积PE。尽管进行了抗凝和机械血栓切除术，但患者在接受肺动脉内膜切除术之前死于并发症。本报告强调了在危急病例中整合临床敏锐度、先进成像模式以及及时进行多学科协作以避免误诊并优化患者治疗结果的重要性。
