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Atypical Presentation of Pulmonary Embolism Several Months After COVID-19 Infection

机译:Covid-19感染后几个月的肺栓塞的非典型介绍

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A 47-year-old female with a past medical history of morbid obesity and hypertension presented with acute onset dizziness that started while she was at work one evening. She did not have chest pain or dyspnea. She had vital signs within an acceptable range, oxygen saturation of 98%-99%, and was not in acute distress. Examination including the Dix-Hallpike maneuver was unremarkable. Computed tomography angiography (CTA) of the head and neck disclosed bilateral pulmonary embolism without any evidence of cerebral ischemia. CTA chest confirmed the diagnosis of bilateral pulmonary emboli. Importantly, besides the obesity, the patient did not have any other risk factors of pulmonary embolism including recent immobilization, surgery, hormonal therapy or contraceptive use, and personal or family history of thromboembolic disorders. However, she was diagnosed with COVID-19 infection six months back with symptoms not requiring hospitalization. Following further workup for her dizziness and neurology evaluation, in the absence of any other plausible etiology, her presenting symptom was attributed to the atypical presentation of pulmonary embolism. She was treated with heparin in the hospital and discharged on apixaban. Her symptoms had resolved at the time of discharge.
机译:一个47岁的女性,过去的病史,病态病史和高血压患有急性发作头晕,同时她在一天晚上工作。她没有胸痛或呼吸困难。她在可接受的范围内患有生命的迹象,氧气饱和度为98%-99%,并没有急性痛苦。审查包括Dix-Hallpike Sereuver不起眼。头部和颈部的计算机断层造影血管造影(CTA)公开了双侧肺栓塞,没有任何脑缺血的证据。 CTA胸部证实了双侧肺栓塞的诊断。重要的是,除了肥胖之外,患者没有任何其他肺栓塞的危险因素,包括最近的固定化,手术,荷尔蒙治疗或避孕药,以及血栓栓塞障碍的个人或家族史。然而,她被诊断出患有Covid-19感染六个月的症状,不需要住院治疗。在对她的头晕和神经病学评估的进一步逐步研究,在没有任何其他合理的病因的情况下,她的呈现症状归因于肺栓塞的非典型呈现。她在医院的肝素治疗并在Apixaban上排出。她的症状在出院时已经解决了。

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