• Sally Ziatabar, Kevin Rabii, Maly N Oron, Varun Shah, Erica Altschul, Oki Ishikawa, Nader Ishak Gabra, Omar H Mahmoud, and Bushra A Mina.
• Department of Internal Medicine, Lenox Hill Hospital, New York, NY. Electronic address: Sziatabar@northwell.edu.
• Chest. 2019 Nov 1; 156 (5): e103-e106.

Case PresentationA 44-year-old man with a history of coronary artery disease, type 2 diabetes mellitus, and OSA reported progressively worsening dyspnea on exertion over a 6-week period. Outpatient CT angiogram revealed a pulmonary artery filling defect. He was sent to the ED where he was started on a heparin drip for unprovoked pulmonary embolism (PE). Echocardiogram revealed normal cardiac function without evidence of right heart strain. Lower extremity ultrasound was negative for DVT. He improved symptomatically, and no risk factors for PE were identified. He was discharged on apixaban. Five weeks later, the patient returned to the ED with hemoptysis. He reported compliance with anticoagulation and improvement of his dyspnea on exertion. History remained negative for recent travel, trauma, surgery, clotting disorders, thromboembolic disease, and alcohol or drug use. He had a 60 pack-year cigarette smoking history and quit 3 months prior.Copyright © 2019 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

20 keywords...

hide…