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BMJ Case Reports 2012; doi:10.1136/bcr-2012-007092
  • Unusual presentation of more common disease/injury

Pulmonary embolism mimicking left-ventricular hypertrophy on ECG

  1. Joseph Yikona2
  1. 1Department of General Surgery, Airedale NHS Foundation Trust, Keighley, UK
  2. 2Department of Emergency Assessment Unit, West Suffolk Hospital NHS Foundation Trust, Bury St Edmunds, UK
  1. Correspondence to Dr Alan Tan, alantanserseng{at}gmail.com

Summary

Patients with pulmonary embolism (PE) can show changes on the ECG. Here, we report the case of a 48-year-old man who initially presented with calf discomfort and swelling. He was discharged with no anticoagulation after a negative complex duplex venous ultrasonography for deep vein thrombosis (DVT). He presented 4 days later with shortness of breath and pleuritic chest pain. Multiple pulmonary emboli were found on CT pulmonary angiogram. His ECGs showed left-ventricular strain which is unusual for PE. He was anticoagulated and discharged. Despite presenting 2 days later with PE-related complications, he eventually recovered well.

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