Comprehensive management of acute pulmonary embolism in primary care using telemedicine in the COVID-era.

BMJ Case Reports
Joshua ChangDavid R Vinson

Abstract

A healthy, active woman in her 70s reported intermittent exertional dyspnoea for 2 months, notable during frequent open-water swimming. Symptoms were similar to an episode of travel-provoked pulmonary embolism 3 years prior. She denied chest pain, cough, fever, extremity complaints and symptoms at rest. Due to the COVID-19 pandemic, her healthcare system was using secure telemedicine to evaluate non-critical complaints. During the initial video visit, she appeared well, conversing normally without laboured breathing. An elevated serum D-dimer prompted CT pulmonary angiography, which identified acute lobar pulmonary embolism. After haematology consultation and telephone conversation with the patient, her physician prescribed rivaroxaban. Her symptoms rapidly improved. She had an uneventful course and is continuing anticoagulation indefinitely. The pandemic has increased the application of telemedicine for acute care complaints. This case illustrates its safe and effective use for comprehensive management of acute pulmonary embolism in the primary care setting.

References

Jul 16, 2005·American Journal of Respiratory and Critical Care Medicine·Drahomir AujeskyMichael J Fine
Jan 31, 2007·Annals of Family Medicine·Amir QaseemUNKNOWN Joint American Academy of Family Physicians/American College of Physicians Panel on Deep Venous Thrombosis/Pulmonary Embolis
Jun 8, 2011·Journal of Thrombosis and Haemostasis : JTH·W ZondagUNKNOWN Hestia Study Investigators
May 13, 2015·Annals of the American Thoracic Society·Roger D Yusen, David Jiménez
Sep 8, 2015·Annals of Internal Medicine·Hilary DanielUNKNOWN Health and Public Policy Committee of the American College of Physicians
Sep 29, 2015·Annals of Internal Medicine·Ali S RajaUNKNOWN Clinical Guidelines Committee of the American College of Physicians
Apr 27, 2016·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Stefan WalenJan Wk van den Berg
May 18, 2016·Annals of Family Medicine·Janneke M T HendriksenGeert-Jan Geersing
Nov 15, 2017·Thrombosis Research·Adi J Klil-DroriVicky Tagalakis
Dec 24, 2017·Journal of Thrombosis and Thrombolysis·Katelyn W SylvesterJean M Connors
Jan 13, 2018·Journal of Telemedicine and Telecare·Clemens Scott KruseMatthew Brooks
Apr 24, 2018·Annals of Emergency Medicine·UNKNOWN American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Thromboembolic Disease:Michael D Brown
Oct 12, 2018·The New England Journal of Medicine·Mary E ReedCraig Wargon
Nov 14, 2018·Annals of Internal Medicine·David R VinsonUNKNOWN eSPEED Investigators of the KP CREST Network
Apr 30, 2019·Annals of Internal Medicine·Mary E ReedCraig Wargon
Aug 11, 2020·Annals of Internal Medicine·Carrie L Nieman, Esther S Oh
Aug 31, 2020·Mayo Clinic Proceedings·Steven LinMargaret Smith
Oct 30, 2020·Postgraduate Medical Journal·Karthikeyan P IyengarZuned Hakim
Nov 17, 2020·JAMA Internal Medicine·Sadiq Y PatelMichael L Barnett
Jan 16, 2021·European Heart Journal. Case Reports·Mohamad KansoLaurence Jesel
Feb 10, 2021·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Paul PorterScott Claxton

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