Massive pulmonary embolism as first presentation of primary antiphospholipid syndrome: a case report and literature review

Abstract

Large pulmonary embolisms (PE) have the potential to cause obstructive shock, a hemodynamic state that is usually fatal without prompt medical interventions. A search for the underlying causes in such presentation is usually postponed to a later stage, as the cause is either not obvious nor does it have immediate management implications. Frequently, history and examination are sufficient to identify the precipitating factors for PE; however, many cases remain idiopathic even after exhausting the investigation resources. Primary antiphospholipid syndrome is a systemic autoimmune disorder that is known to cause a hypercoagulable state. Early diagnosis of antiphospholipid syndrome might have therapeutic implications on the short-term as well as long-term patient management; thus, we suggest that it should be included in the workup of cases presenting with massive PE.

Keywords

• acute respiratory distress syndrome
• massive pulmonary embolism
• primary antiphospholipid syndrome