Unusual Presentation of Pulmonary Embolism as Diaphragmatic Hernia - Case Study

Pulmonary embolism (PE) is a critical condition characterized by thrombi obstructing pulmonary arteries, commonly originating from deep vein thrombosis. Typical symptoms include sudden-onset dyspnea, chest pain, and hypoxemia, although atypical presentations complicate diagnosis. Diaphragmatic hernias, involving abdominal organs displacing into the thoracic cavity, present with respiratory distress and gastrointestinal symptoms. The coexistence of PE and diaphragmatic hernia is rare, posing significant diagnostic challenges. This case report details a 65-year-old female with acute dyspnea and cyanosis following chest trauma, initially misdiagnosed with diaphragmatic hernia. Elevated D-dimer levels and clinical signs suggested PE, but CT pulmonary angiography revealed a large diaphragmatic hernia compressing the pulmonary arteries, causing pulmonary hypertension. This case underscores the importance of comprehensive differential diagnosis and advanced imaging to accurately identify overlapping conditions. It is important to consider differential diagnoses in acute dyspnea cases with atypical findings. Maintaining a broad differential diagnosis and a multidisciplinary approach is crucial to avoid misdiagnosis and ensure timely, appropriate treatment, thereby optimizing patient outcomes.