Pulmonary embolism presenting as exercise-induced hypotension.
A 68-year-old man with remote history of previous myocardial infarction presented with a four-week history of intermittent dyspnea. After developing hypotension during an exercise tolerance test, he underwent cardiac catheterization, revealing significant pulmonary hypertension and two-vessel coronary artery disease. Pulmonary angiography confirmed the presence of pulmonary emboli which partially resolved after thrombolytic therapy. Subsequent treadmill testing confirmed the absence of exercise-induced hypotension two months following treatment. This case underscores the importance of considering pulmonary embolism as a potential cause of exercise-induced hypotension, since it can be successfully treated with thrombolytic agents weeks after the initial onset of symptoms.
Sigal
S L
SL
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
Kolansky
D M
DM
Hughes
S
S
Cabin
H S
HS
Batsford
W P
WP
D000368:Aged; D005080:Exercise Test; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011859:Radiography