Diagnosing pulmonary embolism when the clinical picture is not clear – The role of the point-of-care ultrasound
Torcato Moreira-Marques1, Yale Tung-Chen2, Ana Martinez-Piñero3
1 Department of Internal Medicine, Centro Hospitalar Universitário de Lisboa Central – Hospital de Santa Marta, Unidade Funcional de Medicina Interna, Lisbon, Portugal
2 Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Calle Joaquín Rodrigo, Majadahonda, Madrid, Spain
3 Department of Internal Medicine, Hospital Clínico Universitario de Valencia, Servicio de Urgencias, Valencia, Spain
Department of Internal Medicine, Universitary Hospital of Lisbon Central, Majadahonda, Madrid; Department of Medicine, Universidad Alfonso X El Sabio (Madrid, Spain), Calle Joaquín Rodrigo, N 1. 28222. Majadahonda, Madrid
Source of Support: None, Conflict of Interest: None
Point-of-care ultrasound (POCUS) has become a reliable and powerful tool working as a complement to the traditional physical examination. It has proven to be a reliable and reproducible method to a quicker and safer diagnosis, sometimes surpassing the diagnostic accuracy of more traditional techniques. We present two cases of pulmonary embolism (PE) with clinical presentations that suggested other diagnoses, prior to the performance of POCUS: a 60-year-old patient with nausea and vomiting and a 66-year-old female with a week-long progressive increase of shortness of breath and increased peripheral edema. In the reported cases, we aim to pinpoint the importance and usefulness of POCUS in the everyday evaluation of our patients, in multiple settings and by multiple specialty physicians, supported by its robust evidence-based background. It has proven to be a useful tool in evaluating in a fast and nonharmful way complementing more traditional techniques, which proves to be especially important regarding cases, like the ones we describe, when the correct diagnosis is not always clear to presentation. The use of multiorgan POCUS allows even in the most atypical presentations, the rise of suspicion of PE, leading to the necessary steps to a final diagnosis and management.