Concomitant occurrences of pulmonary embolism and acute myocardial infarction in acute coronary syndrome patient undergoing percutaneous coronary intervention: a case report

ulmonary embolism (PE), a form of venous thromboembolism, is a relatively frequent cardiovascular emergency, and a potentially lifethreatening condition that needs prompt identification and treatment. [1]PE is often misdiagnosed or unrecognized with many patients experiencing atypical symptoms. [2,3]Early diagnosis and treatment of PE are important.In this case, PE was found in a 73-year-old male patient with three-vessel coronary artery disease who underwent percutaneous coronary intervention (PCI) for concomitant acute myocardial infarction (MI).A 73-year-old man with a history of old inferior wall MI, prior PCI of the left anterior descending artery (LAD) and left circumflex artery (LCx), dyslipidemia, type 2 diabetes mellitus, and chronic kidney disease presented to our clinic with chest tightness and palpitations intermittently over a month.He was in New York Heart Association functional (NYHA) class II with no typical symptoms of chest pain, cough, hemoptysis, dyspnea or edema of the lower extremities, but did report sweating.In addition, he denied recent trauma or immobilization, and there was no personal or family history of venous thromboembolism.Medications on admission included aspirin, clopidogrel, metoprolol, isosorbide mononitrate, nicorandil, and atorvastatin.His blood pressure was 131/78 mmHg, heart rate was 70 beats/min, and respiratory rate was 20 breaths/min.Physical examination was unremarkable except for a relative area of dullness in the lower left thoracic region.Laboratory test on admission showed that D-dimer was 702 ng/mL (0-243 ng/mL).Tumor biomarkers, B-