Open AccessMassive pulmonary embolism presenting initially as acute psychosis
Author(s) -
Michael Co,
Arianne Clare Agdamag,
Marcus Juan Esteban,
Roselyn Mateo
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2017-222018
Subject(s) - medicine , pulmonary embolism , thrombolysis , ventricle , atrial fibrillation , psychosis , cardiology , pulmonary embolus , ventricular fibrillation , psychiatry , myocardial infarction
This is a case of a 68-year-old man with Parkinson's disease who was admitted in the psychiatry floor for new-onset aggressive behaviour and hallucinations. On the third day of hospitalisation, he suddenly developed dyspnoea followed by an ECG showing atrial fibrillation with rapid ventricular response. A few seconds later, he went into cardiac arrest; he was resuscitated after multiple rounds of Advanced Cardiovascular Life Support. A transthoracic echo showed hypokinetic and enlarged right ventricle. A CT Chest showed a saddle embolus. Patient was provided with systemic thrombolysis, which led to an improvement in his haemodynamic status. Interestingly, his psychotic symptoms also improved. In this paper, we present and review how pulmonary embolism can be associated with acute psychosis.