Article Text

Unusual presentation of more common disease/injury
Massaging the outcome: an unusual presentation of pulmonary embolism
  1. Danny Chin Guan Lim,
  2. Hari Kishan Jayanthi,
  3. Andrew Money-Kyrle,
  4. Punit Ramrakha
  1. Stoke Mandeville Hospital, Mandeville Road, Aylesbury, Buckinghamshire HP21 8AL, UK
  1. Danny Chin Guan Lim, dcglim{at}


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.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication