Open AccessVaricose Vein Trauma: A Risk for Pulmonary Embolism
Author(s) -
Parijat S. Joy,
Creticus P. Marak,
Anna M. Ponea,
Achuta Kumar Guddati
Publication year - 2014
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2014/8430.5062
Subject(s) - medicine , pulmonary embolism , thrombus , etiology , varicose veins , chest pain , surgery , deep vein , abdomen , radiology , troponin , cardiology , thrombosis , myocardial infarction
Pulmonary embolism (PE) is a deceptive condition which is often incorrectly diagnosed leading to high morbidity and mortality. We present a case where symptoms were localised to different areas of the body starting with post-traumatic pain over lower extremity varicosities that migrated sequentially over a month to the knee, hip, back, abdomen and chest finally presenting as syncope. Despite a low pre-test clinical probability, a very high index of suspicion led to a timely diagnosis of a massive bilateral PE that eventually caused a troponin leak. The aetiology is highly suspicious of a thrombus which originated in the veins of the leg due to trauma over varicose veins.The case described here exemplifies the importance of considering trauma to varicosities as a risk factor for embolism when the clinical picture is concerning but other signs and symptoms of PE are not apparent.