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Published 1 June 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.01.2009.1505]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Unusual presentation of more common disease/injury

Massaging the outcome: an unusual presentation of pulmonary embolism

Danny Chin Guan Lim, Hari Kishan Jayanthi, Andrew Money-Kyrle, Punit Ramrakha

Stoke Mandeville Hospital, Mandeville Road, Aylesbury, Buckinghamshire HP21 8AL, UK

Correspondence to:
Danny Chin Guan Lim, dcglim{at}gmail.com

SUMMARY

A 56-year-old man with a previous deep venous thrombus presented with dyspnoea after a leg massage. A transthoracic echocardiogram demonstrated a "worm-shaped" right atrial embolus, most probably a femoral cast. A pulmonary artery angiogram confirmed a large wedge-shaped perfusion defect caused by a pulmonary embolus. There are previous case reports about leg massage causing pulmonary emboli but this is the first reported event where the thrombus has been visualised directly. Also, it demonstrates the important role that echocardiography plays in pulmonary embolus.


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