Highlights an unusual presentation of massive pulmonary embolism and reviews current treatment options.
Alerts clinicians to atypical PE presentations; leaves open optimal management strategies for incidental massive saddle emboli.
Although the clinical syndrome following pulmonary embolism (PE) may be subtle, in the case of massive PE the severity of the clinical presentation typically makes the picture more obvious. If more than two lobar pulmonary arteries become obstructed, the hemodynamic and respiratory consequences are severe, and may be life threatening. We present an unusual case where a patient experienced transient hemodynamic collapse during valsalva, and a massive saddle pulmonary embolus was discovered incidentally. Current treatment options for massive PE are then discussed.
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Cooper et al. (2002) studied this question.
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