Atypical Presentation of a Pulmonary Embolism in the Perioperative Setting.
We present the case of an asymptomatic 82-year-old patient with no coronary artery disease and a negative cardiac workup who presented to the hospital for an elective total knee replacement. The patient had stable vital signs in the preanesthesia holding unit, yet the anesthesiologist recognized new-onset atrial fibrillation on the patient's monitor. The dysrhythmia was confirmed with a 12-lead electrocardiogram. The procedure was canceled, and the patient was sent for additional evaluation. An echocardiogram revealed a pulmonary embolism. This case report illustrates the need for a questioning attitude and diligent monitoring in all phases of perioperative care.
From the *Miami Beach Anesthesiology Associates, Inc., Miami Beach, Florida; †Department of Anesthesiology, Mount Sinai Medical Center, Miami Beach, Florida; ‡Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and §The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.
Omar
O
Viswanath
Allan F
AF
Simpao
Sushmitha
S
Santhosh
D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D001281:Atrial Fibrillation / Q000209:etiology*; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D008297:Male; D019990:Perioperative Care / Q000379:methods; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis*