Pulmonary embolism in the COVID-19 pandemic era: Importance of bedside electrocardiography, echocardiography and use of Tenecteplase.

Abstract

Pulmonary embolism is a blockage in one of the pulmonary arteries in the lungs. Globally, it is the third most frequent acute cardiovascular syndrome behind myocardial infarction and stroke. This is a 43-yearold Nigerian diabetic man who had liposuction three weeks before presenting with sudden onset breathlessness, productive cough, chest pain, fever, inability to complete a sentence and inability to carry out his normal daily activities during this coronavirus 2019 (COVID-19) pandemic. He was tachypneic, tachycardic, hypotensive with rapidly dropping oxygen saturation (84%-86%, 80%-84%). This presented a diagnostic challenge which was rapidly resolved with bedside electrocardiography and echocardiography. A diagnosis of pulmonary embolism was sustained. Subsequent SARS-COV-2 PCRbased test was negative. He was successfully managed with an antithrombotic agent, tenecteplase, without any adverse events. Keywords: COVID-19, pulmonary embolism, tenecteplase, electrocardiography, echocardiography