University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Emergency Medicine


Thomas Colletti


A pulmonary embolism (PE) occurs when there is a disruption of blood flow in the pulmonary arteries and/or their segmental branches as they leave the right ventricle and travel to the regions of the lungs where they terminate as pulmonary capillaries. Pulmonary embolisms are most often caused by blood thrombi that originate in the vascular system somewhere proximal to the pulmonary circulation. Patients diagnosed with pulmonary embolism present with a wide variety of complaints that range from asymptomatic to shock, or even sudden death. Given the studies utilized to diagnose PEs, they are unlikely to be incidental findings and thus require direct consideration when completely ruling out PE as a differential diagnosis. We present a case report illustrates the importance of pulmonary embolism as a differential diagnosis in the emergency department, especially in patients who present with vague symptoms. In patients with PE, clinical decision tools as well as gestalt is important in preventing missed or overlooked pathology. It benefits both the patient and provider to have a low threshold for including PE in an initial differential diagnosis.

Case Report: An Atypical Presentation for Submassive Saddle Pulmonary Embolism


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