title: Multiple pulmonary thromboembolism and severe depression.
abstract: BACKGROUND
  Depression is known to have a bidirectional relationship with cardiovascular disease. Severe major depression associated with psychomotor retardation and immobility can be a risk factor for pulmonary embolism; the reverse pathway has not been reported.
  
  
  METHODS
  We report a case of a 61-year-old man diagnosed with multiple pulmonary thromboembolism finally attributed to a right pulmonary artery intraluminal sarcoma. One month after the onset of presenting symptoms, the patient suddenly developed an episode of severe, melancholic depression, which remitted in six weeks under treatment with venlafaxine 225 mg/day.
  
  
  CONCLUSIONS
  Pathophysiological mechanisms implicated in the development of depression in our patient might resemble those postulated for post-myocardial infarction depression; in line with the "vascular depression" hypothesis, cerebral damage in the limbic circuitry caused by transient hypoxia, an inflammatory response or both may have contributed.
  
  
  CONCLUSIONS
  Multiple pulmonary thromboembolism seems to have a bidirectional relationship with major depression, in a similar way as myocardial infarction does.
authors.affiliation: 2nd Department of Psychiatry, ATTIKON University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece. pferentinos@med.uoa.gr
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Ferentinos
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Rizos
authors.forename: Christos
authors.initials: C
authors.lastname: Christodoulou
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Nikolaidou
authors.forename: Despoina
authors.initials: D
authors.lastname: Chatzilia
authors.forename: Stelios
authors.initials: S
authors.lastname: Loukides
authors.forename: Spyros
authors.initials: S
authors.lastname: Papiris
authors.forename: Lefteris
authors.initials: L
authors.lastname: Lykouras
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D003299:Cooperative Behavior; D003511:Cyclohexanols / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D003937:Diagnosis, Differential; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011651:Pulmonary Artery; D011655:Pulmonary Embolism / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D012307:Risk Factors; D012509:Sarcoma / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D019043:Vascular Neoplasms / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D000069470:Venlafaxine Hydrochloride
chemical_list: D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride