May 5, 2022, 3:56 AM
Acute pulmonary embolism (PE) is a common complication of deep vein thrombosis (DVT) or atrial fibrillation and is associated with many sudden deaths (Morrone & Morrone, 2018). In the United States, PE accounts for 200 to 300 thousand each year (Morrone & Morrone, 2018). The risk factors of PE include obesity, tobacco abuse, trauma, contraceptives, etc. (Morrone & Morrone, 2018). The clinical presentation of PE varies on many occasions because cases may present asymptomatic and, in most cases, may seek medical attention with obvious symptoms (Morrone & Morrone, 2018).
The Darrin Lancaster case presented medical attention with a sudden onset of shortness of breath. However, the patient denies any possible symptoms that suggest infections and trauma. The diagnostic tool used to support the final clinical impression was chest CT with contrast. In this clinical case scenario, the patient presented with sudden onset of pain consistent with pleuritic chest pain at the medical practice. The differential diagnosis in this case scenario can vary from acute coronary syndromes, pleuritic chest pain from an infectious process, and spontaneous pneumothorax (Morrone & Morrone, 2018; Yamamoto, 2018).
In most cases, diagnosing is straightforward and does not require complex and unnecessary testing (Konstantinides et al., 2020). Therefore, the key element in the prompt and accurate diagnosis of PE should be lifted from the patient's history of present illness (Konstantinides et al., 2020). Therefore, the assessment process should follow a stepwise procedure and order diagnostic biomarkers to both support and rule out PE (Konstantinides et al., 2020). In addition, risk stratification from a validated scoring system to assist the clinical decision to either consider or rule out PE is also an important yet inexpensive approach to providing high-quality care (Simon et al., 2021; Konstantinides et al., 2020).
Morrone, D., & Morrone, V. (2018). Acute Pulmonary Embolism: Focus on the Clinical Picture. Korean circulation journal, 48(5), 365–381. https://doi.org/10.4070/kcj.2017.0314
Konstantinides, S. V. et al. (2020). ESC Scientific Document Group, 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC), European Heart Journal, 41(4), 543–603. https://doi.org/10.1093/eurheartj/ehz405
Simon, M.A. et al. (2021). Effectiveness of Clinical Decision Tools in Predicting Pulmonary Embolism. Pulmonary Medicine, 8880893. https://doi.org/10.1155/2021/8880893