PT  - JOURNAL ARTICLE
AU  - Joshua Chang
AU  - Dayna J Isaacs
AU  - Joseph Leung
AU  - David R Vinson
TI  - Comprehensive management of acute pulmonary embolism in primary care using telemedicine in the COVID-era
AID  - 10.1136/bcr-2021-243083
DP  - 2021 Jun 01
TA  - BMJ Case Reports
PG  - e243083
VI  - 14
IP  - 6
4099  - http://casereports.bmj.com/content/14/6/e243083.short
4100  - http://casereports.bmj.com/content/14/6/e243083.full
SO  - BMJ Case Reports2021 Jun 01; 14
AB  - A healthy, active woman in her 70s reported intermittent exertional dyspnoea for 2 months, notable during frequent open-water swimming. Symptoms were similar to an episode of travel-provoked pulmonary embolism 3 years prior. She denied chest pain, cough, fever, extremity complaints and symptoms at rest. Due to the COVID-19 pandemic, her healthcare system was using secure telemedicine to evaluate non-critical complaints. During the initial video visit, she appeared well, conversing normally without laboured breathing. An elevated serum D-dimer prompted CT pulmonary angiography, which identified acute lobar pulmonary embolism. After haematology consultation and telephone conversation with the patient, her physician prescribed rivaroxaban. Her symptoms rapidly improved. She had an uneventful course and is continuing anticoagulation indefinitely. The pandemic has increased the application of telemedicine for acute care complaints. This case illustrates its safe and effective use for comprehensive management of acute pulmonary embolism in the primary care setting.