Key result
CT angiography identifies acute pulmonary embolism presenting as cardiac, cerebral, or traumatic brain injury masks.
Why the study?
Pulmonary embolism has main clinical masks that may complicate timely diagnosis, prompting an analysis to systematize them.
Case Report (n=3)
No
Pulmonary embolism frequently masquerades as acute cardiac, cerebrovascular, or traumatic conditions, underscoring the need for high clinical vigilance and timely use of validated clinical scales, D-dimer testing, and CT angiography.
Answers are grounded in this paper and cite their sources.
Supports considering PE in atypical cardiac or neurological presentations; leaves open whether diagnostic algorithms improve outcomes.
Aim: to systematize the main "clinical masks" of pulmonary embolism (PE) that may complicate timely diagnosis, based on the analysis of clinical case reports at the Regional Vascular Center. Anamnesis, complaints, physical examination data, electrocardiography, echocardiography, duplex scanning of the lower extremity veins, com- puted tomography (CT), and laboratory parameters were evaluated in all patients. The diagnosis of PE was confirmed by CT angiography (CTA). In all three cases, the initial diagnosis did not correspond to PE. In a 68yearold patient with arterial hypertension, PE was masked as acute coronary syndrome (i. e., a "cardiac mask"). As for a 66yearold patient, a syncopal episode led to suspicious acute cerebrovascular accident, a "cerebral mask". Finally, PE manifested with loss of consciousness and head trauma associated with postoperative hypodynamia which was interpreted as a traumatic brain injury in a 56yearold female. Thus, as PE often masquerades as other diseases, this requires high clinical vigilance from physi - cians. Validated scales, Ddimer assay, and CT angiography are key diagnostic elements. KEYWORDS: PE, pulmonary embolism, clinical masks, diagnosis, Ddimer, CTA FOR CITATION: Lobanova O.S., Dudarenko S.V., Gaydukova I.Z. Clinical masks of pulmonary embolism: experience of the Regional Vascular Center. Russian Medical Inquiry. 2026;10(9):629–635 (in Russ.). DOI: 10.32364/2587-6821-2026-10-9-6
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Lobanova et al. (2026) conducted a case report in Pulmonary embolism (n=3). CT angiography and D-dimer diagnostic workup was evaluated on Confirmation of pulmonary embolism and characterization of initial clinical misdiagnoses (clinical masks). CT angiography confirmed pulmonary embolism in 3 patients (ages 56, 66, and 68) after 100% were initially misdiagnosed with cardiac, cerebral, or traumatic brain injury masks.
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