Why the study?
Pulmonary embolism is a life-threatening emergency that is often misdiagnosed due to a wide variety of clinical manifestations and potential diagnostic confusion with acute coronary syndrome.
Bilateral large pulmonary embolism can present atypically without classical respiratory symptoms and mimic ST-elevation myocardial infarction on ECG, requiring careful evaluation to avoid misdiagnosis.
Supports including PE in STEMI-mimic differentials lacking respiratory symptoms; leaves open confirmatory data from larger studies.
ZPulmonary embolism (PE) is a common and life-threatening medical emergency, but it is still often misdiagnosed due to its wide variety of clinical manifestations.We report a case of a 78-year-old man who presented with urinary retention without any classical symptoms, and was found to have bilateral large PE as confirmed by computed tomography pulmonary angiogram.Initial electrocardiogram (ECG) showed ST segment elevation and T-wave inversion in anteroseptal and inferior leads, with reciprocal changes in lateral leads.Clinicians need to be aware that a diagnostic dilemma between PE and acute coronary syndrome is not uncommon, as both conditions can present with "ischemic-looking" ECG and elevated troponin levels.To our knowledge, this is the first case of an atypical, incidental finding of PE in a patient who presented with urinary retention reported in the literature.Careful analysis and interpretation of ECG are necessary to improve patient evaluation and support clinical decision-making in order to provide the best possible care.
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May Honey Ohn (2025) studied this question.
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