A patient with a large pulmonary saddle embolus eluding both clinical gestalt and validated decision rules.

Hennessey, Adam; Setyono, Devy A; Lau, Wayne Bond; Fields, Jason Matthew · Ann Emerg Med · 2012

case_report · Level V

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Abstract

We report a patient with chest pain who was classified as having low risk for pulmonary embolism with clinical gestalt and accepted clinical decision rules. An inadvertently ordered D-dimer and abnormal result, however, led to the identification of a large saddle embolus. This case illustrates the fallibility of even well-validated decision aids and that an embolism missed by these tools is not necessarily low risk or indicative of a low clot burden.

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