Varicose Vein Trauma: A Risk for Pulmonary Embolism
MD05-MD07
Correspondence
Dr. Parijat S Joy,
Associate Phycisian, Department of Internal Medicine, University of Iowa Hospitals and Clinics,
University of Iowa, Iowa, IA- 52242, USA.
Phone: 267-979-8293, E-mail: joymedicine2@gmail.com
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