tetano
Editor, Senior Moderator
Cureus
. 2020 Jul 19;12(7):e9266.
doi: 10.7759/cureus.9266.
COVID-19 Presenting as Acute Bilateral Submassive Pulmonary Embolism in a Young Healthy Female
Mina Fransawy Alkomos[SUP] 1 [/SUP], Polina Aron[SUP] 1 [/SUP], Ian Laxina[SUP] 1 [/SUP], Jessimar Sanchez[SUP] 1 [/SUP], Michael Agnelli[SUP] 1 [/SUP]
Affiliations
Abstract
Similar symptoms, signs, and laboratory abnormalities between coronavirus disease 2019 (COVID-19) and pulmonary embolism (PE) creates a diagnostic challenge to every physician, and emerging data show an association between COVID-19, hypercoagulable state, and venous thromboembolism. We present a rare case of COVID-19 presented as bilateral sub-massive PE. A 28-year-old COVID-19 positive female with no significant past medical history presented with a dry cough and shortness of breath for three days. Initial laboratory test showed elevated D-dimer, electrocardiogram (EKG) showed right axis deviation, right ventricular strain pattern, and S[SUB]I[/SUB] Q[SUB]III[/SUB] T[SUB]III[/SUB] pattern, and echocardiogram (ECHO) showed right ventricular dysfunction. Those two bedside tests directed the urgency of chest CT angiography that showed bilateral sub-massive PE. Since EKG finding of S[SUB]I[/SUB] Q[SUB]III[/SUB] T[SUB]III[/SUB] pattern and right ventricular strain, and ECHO finding of right ventricular dysfunction are well described in PE but not in COVID-19, these bedside diagnostic tools can help identify COVID-19 patients with underlining PEs.
Keywords: computed tomography pulmonary angiography; corona virus disease 2019; pulmonary thromboembolism.
. 2020 Jul 19;12(7):e9266.
doi: 10.7759/cureus.9266.
COVID-19 Presenting as Acute Bilateral Submassive Pulmonary Embolism in a Young Healthy Female
Mina Fransawy Alkomos[SUP] 1 [/SUP], Polina Aron[SUP] 1 [/SUP], Ian Laxina[SUP] 1 [/SUP], Jessimar Sanchez[SUP] 1 [/SUP], Michael Agnelli[SUP] 1 [/SUP]
Affiliations
- PMID: 32821612
- PMCID: PMC7431300
- DOI: 10.7759/cureus.9266
Abstract
Similar symptoms, signs, and laboratory abnormalities between coronavirus disease 2019 (COVID-19) and pulmonary embolism (PE) creates a diagnostic challenge to every physician, and emerging data show an association between COVID-19, hypercoagulable state, and venous thromboembolism. We present a rare case of COVID-19 presented as bilateral sub-massive PE. A 28-year-old COVID-19 positive female with no significant past medical history presented with a dry cough and shortness of breath for three days. Initial laboratory test showed elevated D-dimer, electrocardiogram (EKG) showed right axis deviation, right ventricular strain pattern, and S[SUB]I[/SUB] Q[SUB]III[/SUB] T[SUB]III[/SUB] pattern, and echocardiogram (ECHO) showed right ventricular dysfunction. Those two bedside tests directed the urgency of chest CT angiography that showed bilateral sub-massive PE. Since EKG finding of S[SUB]I[/SUB] Q[SUB]III[/SUB] T[SUB]III[/SUB] pattern and right ventricular strain, and ECHO finding of right ventricular dysfunction are well described in PE but not in COVID-19, these bedside diagnostic tools can help identify COVID-19 patients with underlining PEs.
Keywords: computed tomography pulmonary angiography; corona virus disease 2019; pulmonary thromboembolism.