Emergent mechanical thrombectomy led to clinical improvement and stabilization in a 43-year-old female presenting with massive pulmonary embolism and the classic S1Q3T3 electrocardiographic pattern.
Case Report (n=1)
Prompt recognition of classic ECG findings (S1Q3T3) and biomarkers in massive pulmonary embolism facilitates lifesaving mechanical thrombectomy.
Abstract Massive pulmonary embolism (PE) is a life-threatening condition characterized by hemodynamic instability and right ventricular (RV) dysfunction. Recognition of its classic clinical, laboratory, and electrocardiographic findings remains essential for timely intervention. Case Presentation A 43-year-old female with a history of multiple sclerosis presented with acute-onset dyspnea and pleuritic chest discomfort for 1 day. On arrival, she was tachycardic, hypotensive, and hypoxic, requiring supplemental oxygen and intravenous fluids. Laboratory evaluation revealed elevated lactic acid, brain natriuretic peptide (BNP), and troponin levels, suggestive of right heart strain. Electrocardiogram (ECG) demonstrated the classic S1Q3T3 pattern. Computed tomography angiography (CTA) of the chest confirmed a saddle, massive, pulmonary embolus with evidence of RV dilation and strain. Given her hemodynamic instability and imaging findings, the patient underwent emergent mechanical thrombectomy with subsequent clinical improvement and stabilization. This case highlights the importance of recognizing the hallmark features of massive PE—dyspnea with hypoxia, tachycardia, biomarker elevation, and the S1Q3T3 pattern on EKG. Prompt diagnosis and rapid initiation of definitive therapy, including mechanical thrombectomy, can be lifesaving. These classic findings of massive pulmonary embolism remain critical diagnostic clues. Awareness of these features facilitates early recognition and timely management, improving patient outcomes in acute PE presentations. This abstract is funded by: None
Mccoy et al. (Fri,) conducted a case report in Massive pulmonary embolism (n=1). Mechanical thrombectomy was evaluated on Clinical improvement and stabilization. Emergent mechanical thrombectomy led to clinical improvement and stabilization in a 43-year-old female presenting with massive pulmonary embolism and the classic S1Q3T3 electrocardiographic pattern.