title: Pulmonary vein thrombosis in a patient with polycythemia vera.
abstract: Pulmonary vein thrombosis (PVT) is a rarely encountered disease entity with varied clinical presentations. It is usually associated with lung carcinoma, lung surgeries and as a complication of the radiofrequency catheter ablation procedure for atrial fibrillation. Its clinical manifestations can vary from mild hemoptysis to lung infarction with hemodynamic compromise. A 76-year-old male presented with a 2-d history of pleuritic left sided chest pain. His past medical history included polycythemia vera, atrial fibrillation, coronary artery disease, pulmonary embolism and pulmonary hypertension. Chest radiograph was normal, troponins were normal and the 12-lead electrocardiogram did not show any ischemic changes. A computerized tomography pulmonary angiogram revealed a filling defect in the left lower lobe pulmonary vein. He was treated with subcutaneous enoxaparin and his symptoms improved. This case highlights a rare etiology of chest pain and the first reported case of the association of polycythemia vera and pulmonary vein thrombosis. A high index of suspicion is required for appropriate diagnostic work up. PVT can mimic pulmonary embolism. The diagnostic work up and treatment strategies depend on acuity of presentation.
authors.affiliation: Bhaskar Bhardwaj, Dany Jacob, Amit Sharma, Mouhanna Abu Ghanimeh, Department of Internal Medicine, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, United States.
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Bhardwaj
authors.affiliation: Bhaskar Bhardwaj, Dany Jacob, Amit Sharma, Mouhanna Abu Ghanimeh, Department of Internal Medicine, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, United States.
authors.forename: Dany
authors.initials: D
authors.lastname: Jacob
authors.affiliation: Bhaskar Bhardwaj, Dany Jacob, Amit Sharma, Mouhanna Abu Ghanimeh, Department of Internal Medicine, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, United States.
authors.forename: Amit
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Bhaskar Bhardwaj, Dany Jacob, Amit Sharma, Mouhanna Abu Ghanimeh, Department of Internal Medicine, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, United States.
authors.forename: Mouhanna Abu
authors.initials: MA
authors.lastname: Ghanimeh
authors.affiliation: Bhaskar Bhardwaj, Dany Jacob, Amit Sharma, Mouhanna Abu Ghanimeh, Department of Internal Medicine, University of Missouri Kansas City School of Medicine, Kansas City, MO 64108, United States.
authors.forename: Paramdeep
authors.initials: P
authors.lastname: Baweja
keywords: Polycythemia rubra vera; Pulmonary veins; Thrombosis/etiology; Thrombosis/radiography