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Vol 14, No 2 (2019)
Case report
Published online: 2019-05-22

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A diagnostic pitfall: angina pectoris and intermittent left bundle branch block in a 68 year-old woman with pulmonary embolism — one year follow-up. A case report

Aneta Małgorzata Kucharczyk-Foltyn1
Folia Cardiologica 2019;14(2):189-193.

Abstract

In the present communication, a case of a 68 year-old woman consulted at a cardiology service due to angina pectoris is reported. The electrocardiogram (ECG) showed intermittent left bundle branch block. Transthoracic echocardiography revealed signs of pulmonary embolism. The diagnosis was confirmed by computed tomography angiography. The presented case highlights the role of echocardiography in the differential diagnosis of anginal pain and shows that making a correct diagnosis based on ECG may sometimes be challenging. 

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References

  1. Torbicki A, Pruszczyk P. Rozpoznanie zatoru tętnicy płucnej. In: Łopaciuk S. ed. Zakrzepy i zatory. PZWL, Warszawa 2002: 367–381.
  2. Stein P, Terrin M, Hales C, et al. Clinical, Laboratory, Roentgenographic, and Electrocardiographic Findings in Patients with Acute Pulmonary Embolism and No Pre-Existing Cardiac or Pulmonary Disease. Chest. 1991; 100(3): 598–603.
  3. Kucharczyk-Foltyn A, Sniezek-Maciejewska M, Tomala I, et al. Submassive pulmonary embolism as a mask of acute coronary syndrome. Cardiol J. 2007; 14(4): 402–406.
  4. Stein PD, Henry JW. Clinical characteristics of patients with acute pulmonary embolism stratified according to their presenting syndromes. Chest. 1997; 112(4): 974–979.
  5. Konstantinides S, Torbicki A, Agnelli G, et al. Wytyczne ESC dotyczące rozpoznawania i postępowania w ostrej zatorowości płucnej w 2014 roku. Kardiologia Polska. 2014; 72(11): 997–1053.
  6. Libionka A, Libionka W, Nessler J, et al. Znaczenie rokownicze przemijającego bloku lewej odnogi pęczka Hisa występującego w czasie próby wysiłkowej. Folia Cardiol. 2002; 9(6): 491–497.
  7. Wayne V, Bishop R, Cook L, et al. Exercise-induced bundle branch block. The American Journal of Cardiology. 1983; 52(3): 283–286.
  8. Abben R, Rosen KM, Denes P. Intermittent left bundle branch block: anatomic substrate as reflected in the electrocardiogram during normal conduction. Circulation. 1979; 59(5): 1040–1043.
  9. Torbicki A, Perrier A, Konstantinides S, et al. Guidelines and management of acute pulmonary emboliom of European Society of cardiology. Eur. Heart J. 2008; 29: 2276–315.
  10. Geibel A, Zehender M, Kasper W, et al. Prognostic value of the ECG on admission in patients with acute major pulmonary embolism. Eur Respir J. 2005; 25(5): 843–848.
  11. Farrell C, Jones M, Girvin F, et al. Unsuspected pulmonary embolism identified using multidetector computed tomography in hospital outpatients. Clin Radiol. 2010; 65(1): 1–5.
  12. Jia CF, Li YX, Yang ZQ, et al. Prospective evaluation of unsuspected pulmonary embolism on coronary computed tomographic angiography. J Comput Assist Tomogr. 2012; 36(2): 187–190.