Skip to main content

Pulmonary Embolism Patient- Clinical Scenario and Diagnosis-

•A 42 year old lady from murree visited our hospital for the evaluation of her left leg swelling that she noticed about 2 weeks back. While entering through the gate of Holyfamily Hospital she suddenly collapsed and was rushed to Emergency Department, where she regained consciousness but was dyspneic. Her examination was unremarkable except for a respiratory rate of 32/min.


What is the likely clinical diagnosis? How it can be confirmed? And how will you further evaluate this patient?

Post your answer as comment (scroll down). and answer or further follow up will be presented after 5 answers. 
D-dimers of the patient were advised

Patients value:   1600ng/ml
Normal value:  <200ng/ml

Doppler studies were performed
Venous Doppler left lower limb showed evidence of Deep Venous Thrombosis(DVT)

chest ct scan in pulmonary embolism

This is a classical scenario of Pulmonary Embolism.
ECG shows Q3T3 pattern in our patient

pulmonary embolism ecg
A classical ECG in a pulmonary embolism patient shows S1Q3T3

•D-dimers are markedly elevated and there is established DVT
•CT chest proved pulmonary embolism, showing hypo dense areas in bilateral main pulmonary arteries territory



  1. This comment has been removed by the author.

  2. Dr haseeb tell about the likely diagnosis.. don't just interpret the ecg. from the history tell the likely diagnosis.. question is what is the likely diagnosis and how will confirm it etc.. :)

  3. This comment has been removed by the author.

  4. This comment has been removed by the author.

  5. This comment has been removed by the author.

  6. Yup... The probable diagnosis from the above evidences might be "Cor Pulmonale"


  8. most probably deep vein thrombosis leading to distal embolism in pulmonary artery leading to sudden collapse.
    right heart failure developed afterwards.
    Lower limb doppler ultrasound, duplex scan, venography
    Ecg and Echo for any source of thrombi

  9. Exactly its Pulmonary embolism as she presentd with sudden collaps wid only one leg sweling with just 2 week history and on ecg one othr thing which favouring PE is Q in III T invrted and S wave in Lead it shows She had DVT of left leg which cause embolism.

  10. lol .. mitral stenosis .. what points went towards mitral stenosis?



Post a Comment

Post Your Reply and Give Your Opinion About the Post

Popular posts from this blog

Human Parasites, Types of Parasites, and Classification

Parasite: A parasite is a living organism which gets nutrition and protection from another organism where it lives. Parasites enter into the human body through mouth, skin and genitalia. In this article, we will generally discuss the types and classification of parasites. It is important from an academic point of view. Those parasites are harmful, which derives their nutrition and other benefits from the host and host get nothing in return but suffers from some injury. Types of Parasites Ecto-parasite: An ectoparasite lives outside on the surface of the body of the host. Endo-parasite: An endo-parasite lives inside the body of the host, it lives in the blood, tissues, body cavities, digestive tract or other organs. Temporary parasite: A temporary parasite visits its host for a short period of time. Permanent parasite: Permanent parasite lives its whole life in the host. Facultative parasite: A facultative parasite can live both independently and dependently. It lives in the

How to taper off, wean off beta blocker, atenolol, Propranolol, Metoprolol

Beta blockers include, atenolol (Tenormin), propranolol (Inderal ) and metoprolol (Lopressor) and are used to treat high blood pressure, certain cardiac problems, migraine and few other conditions. People usually take atenolol, propranolol or metoprolol for many years as a treatment of high blood pressure or after having an episode of heart attack . Sometimes, it becomes necessary to withdraw these beta blockers due to their potential side effects that trouble the patients or sometimes doctor wants to change the drug and shift the patient to some other anti-hypertensive medicine. No matter whatever the cause is, whenever, a patient who has been using a beta blocker for a long period of time, and he needs to be stopped from further usage of that beta blocker, must not stop taking it. One should taper off the dose of a beta blocker. Now a question arises how to wean off or taper off a beta blocker? The method of tapering off beta blocker varies from individual to individual. Allow you

Difficulty in standing up from a sitting or squatting position, Causes & Solution

People who feel it difficult to stand up from a sitting or squatting position may have problem in one or more of the following structures. 1. Knee joint 2. Muscles of legs, thighs or buttock 3. Muscles of arms 4. Cerebellum Let’s now explain one by one, what kind of problems in above structures may cause difficulty in standing up from a sitting or squatting position. 1. How do problems in knee joints lead to difficulty in standing up? Knee joint is one of the primary and most affected joint that takes part in standing up. Other joints that take part are hip, ankle, knee, elbow, wrist and shoulder joint. Knee joint gets the most strain , and also knee joint is comparatively less supported. That’s why usually it’s the knee joint that starts to cry first because of arthritis. Knee joint arthritis causes long term knee pain , that makes the movement difficult at knee joint. Arthritis also makes the knee joint stiffer and slower and its range of motion also decreases. All these affects coll