Vnitr Lek 2004, 50(10):793-798

[Pulmonary embolism, prolonged diagnosis in young man].

M Belicová, M Knazeje, M Lojdlová, M Mokán: I. interná klinika Jeseniovej Lekárskej fakulty UK a Martinskej fakultnej nemocnice, Martin, Slovenská republika.

Despite progress in early detection and treatment, the rates of mortality and recurrences of pulmonary embolism remain high. Cardiovascular specialists must keep pulmonary embolism in mind when they evaluate patients with unexplained substernal or pleuritic chest pain, dyspnea and syncope because these symptoms constitute the cardinal clinical presentation of pulmonary embolism. Authors are presenting a case report of a patient with repeating pleuritic chest pain with pleural effusion. The patient was treated as suspected tuberculous pleuritis. Authors diagnosed pulmonary embolism as a cause of pleural effusion by elevated plasmatic D-dimer and perfusion lung scan. Thrombosis in left subclavian vein established by angiography was source of embolus. Patient was evaluated regarding primary risk factors for venous thromboembolism and Prothrombin 20210A mutation was detected. Subsequent adequate medical treatment led to significant clinical upturn in this patient.