Is it always anterior chest pain angina pectoris?

Viviana Aursulesei, Ana-Maria Buburuz, Siminela Bulughiana, Irina Iuliana Costache


Acute pulmonary embolism still remains a difficult diagnosis because of its chameleonic clinical presentation. Although it is a common clinical scenario, PE is frequently underdiagnosed. We report a case of acute PE that highlights the importance of a diagnostic strategy based on clinical probability assessed by a validated prediction rule. Our report is also highly suggestive for the importance of computed tomographic angiography, the most useful imaging method that provide direct signs for diagnosis and also significant information on alternative clinical conditions. A useful conclusion for clinical practice is that any data must be rationally judged, considering the limits of clinical diagnosis and laboratory tests.


pulmonary embolism, angina pectoris, computed tomographic angiography

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van Belle A, Büller HR, Huisman MV, et al. Effectiveness of Managing Suspected Pulmonary Embolism Using an Algorithm Combining Clinical Probability, D-Dimer Testing, and Computed Tomography. JAMA 2006; 295:172-179.

Konstantinides S, Torbicki A, Agnelli G, et al. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014; 35:3033-3080.

Pollack CV, Schreiber D, Goldhaber SZ, et al. Clinical characteristics, management, and outcomes of patients diagnosed with acute pulmonary embolism in the emergency department: initial report of EMPEROR (Multicenter Emergency Medicine Pulmonary Embolism in the Real World Registry). J Am Coll Cardiol 2011; 57(6):700-706.

Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999; 353(9162):1386-9.

Heit JA III, Silverstein MD, Mohr DN, et al. Risk factors for deep vein thrombosis and pulmonary embolism: a population based case-control study. Arch Intern Med 2000; 160(6):809-815.

Ward MJ, Sodickson A, Diercks DB, Raja AS. Cost-effectiveness of lower extremity compression ultrasound in emergency department patients with a high risk of hemodynamically stable pulmonary embolism. Acad Emerg Med 2011; 18(1):22-31.

Hauret L, Minvielle F, Ehre P, et al. Metastasis in pulmonary arteries. J Radiol 2000; 81:807-809.

Travis WD, Brambilla E, Noguchi M, et al. Diagnosis of Lung Cancer in Small Biopsies and Cytology. Implications of the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification. Arch Pathol Lab Med 2013; 137:668-684.


Copyright (c) 2016 Viviana Aursulesei, Ana-Maria Buburuz, Siminela Bulughiana, Irina Iuliana Costache

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ISSN: 2360-6975