並列摘要
Pulmonary embolism is a frequently missed diagnosis. We report a patient with a chief complaint of dyspnea. Physical examination showed rapid shallow breathing without wheezing. Echocardiography revealed normal left ventricular function, an ejection fraction of approximately 62%, right ventricular dilatation, pulmonary hypertension and severe tricuspid reflux. Electrocardiography showed right ventricular dilatation and an S1 Q3 T3 wave. Arterial blood gas analysis showed hypoxemia, hypocapnia and an increased alveolar-arterial oxygen concentration gradient. Blood tests showed a D-dimer level of 1206 ng/mL. Chest computed tomography showed bilateral pulmonary embolisms. The bilateral pulmonary emboli were surgically removed under the use of cardiopulmonary bypass.
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