One Case Report Of Atypical Acute Pulmonary Embolism And Retrospective Analysis Of The Early Diagnostic Clues

Objective:To improve the clinician recognition of atypical acute pulmonary embolism and early diagnostic clues, in order to increase early clinical detection rates, reduce the rate of misdiagnosis.Methods:We reported one case of atypical acute pulmonary embolism, to explore the pathophysiology, pathogenesis, clinical manifestations, imaging findings, diagnosis and differential diagnosis of such diseases through analyzing clinical data retrospectively and retrieving the relevant medical literature.Results:Clinical manifestations of acute pulmonary embolism are closely related with pathophysiology changes, differences between individual anatomical, basic diseases and compensatory ability of heart and lungs. Young people of no basic cardiopulmonary disease with good body compensatory ability, often has atypical clinical manifestations. In the early stage,patients can only manifested as cough, expectoration or non-specific changes of other system, typical manifestations such as chest pain, chest tightness, difficulty in breathing and other symptoms are rare. More prominent changes in the assistant examinations are myocardial enzymes in serum, myocardial injury markers,ECG and D-dimer. myocardial enzymes in serum, myocardial injury markers are significantly increased, the ECG manifested as a transient and varied changes of the heart muscle damage,D-dimer increased significantly.The pathophysiology process of acute pulmonary embolism is the blocking of pulmonary artery caused by embolic. Pathophysiological mechanisms is that mechanic embolization of embolic and also neurohumoral mechanisms,this changes cause hypertension of pulmonary and then in turn resulting in increasing afterload of right ventricular,the pressure between aorta and right ventricular is reducing, all the above make the result of hypoperfusion in coronary artery, combined with the releasing of various humoral factors causing the secondary pathological changes of myocardial cells,this is why the clinical manifestations of cardiovascular disease exist to easily result in misdiagnosis and missed diagnosis of pulmonary embolism. Massive pulmonary embolism is easy to cause the blood flow dynamics changes dramatically, if not timely diagnosed and treated, the mortality rate is high. If we could make a correct diagnosis, and anticoagulant, thrombolytic therapy are actively given,we can greatly reduce the mortality of the disease and improve prognosis.Conclusions:Young people without basic cardiopulmonary disease suffering from acute pulmonary embolism is not common, there has less clinical literature reports.The clinical manifestations of pulmonary embolism is not typical, it is easy to be confused with the other cardiac and pulmonary disease. Clinicians should raise awareness and understanding of this kind of patients and master the specific assistant examination systemticly, to predominate the pathophysiology of the disease in order to improve disease detection and cure rates.