title: Fatal pulmonary embolization after negative serial ultrasounds.
abstract: BACKGROUND
  Isolated distal deep vein thrombosis (DVT) is not traditionally viewed as a potentially life-threatening condition. There are conflicting recommendations regarding its evaluation and treatment, and wide variability in clinical practice. The presentation of this case highlights the fatal potential of this condition.
  
  
  METHODS
  This is the report of a previously healthy young woman who presented to the emergency department with calf pain concerning for a DVT. She received two radiologist-performed duplex ultrasound examinations of the affected extremity, both of which were negative, but suffered a sudden cardiac arrest several hours after the second study. Autopsy attributed the death to DVT and pulmonary embolism. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the risk for fatal pulmonary embolization, even after normal serial ultrasound examinations to exclude DVT.
authors.affiliation: Department of Medicine, University of California, San Diego, San Diego, California.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Tainter
authors.affiliation: Elmhurst Hospital Center, Mount Sinai School of Medicine, New York, New York.
authors.forename: Alan W
authors.initials: AW
authors.lastname: Huang
authors.affiliation: Elmhurst Hospital Center, Mount Sinai School of Medicine, New York, New York.
authors.forename: Reuben J
authors.initials: RJ
authors.lastname: Strayer
mesh_terms: D000328:Adult; D016757:Death, Sudden, Cardiac / Q000209:etiology; D005188:False Negative Reactions; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D011655:Pulmonary Embolism / Q000209:etiology*; D018616:Ultrasonography, Doppler, Duplex; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*
keywords: deep vein thrombosis; distal; duplex; pulmonary embolism; thromboembolism; ultrasound; venous