title: Pulmonary embolism presenting as exercise-induced hypotension.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
authors.forename: S L
authors.initials: SL
authors.lastname: Sigal
authors.forename: D M
authors.initials: DM
authors.lastname: Kolansky
authors.forename: S
authors.initials: S
authors.lastname: Hughes
authors.forename: H S
authors.initials: HS
authors.lastname: Cabin
authors.forename: W P
authors.initials: WP
authors.lastname: Batsford
mesh_terms: 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