Pulmonary embolism in a British soldier: could this have been prevented?

Journal of the Royal Army Medical Corps
Rebecca Saveker

Abstract

A 31-year-old soldier presented to the medical centre with acute onset pleuritic chest pain and shortness of breath. He had previously presented to combat medical technicians (CMTs) on two occasions over 2 weeks with right calf pain following a long-distance drive. On both occasions, he was managed as a musculoskeletal disorder without referral to a medical officer (MO). Following this presentation, he presented 4 days later to an MO who referred to secondary care where he was diagnosed with a pulmonary embolism (PE) and deep vein thrombosis (DVT). The CMT treatment protocol does not include the differential diagnosis, history or exam of DVT for lower leg pain. The soldier was subsequently diagnosed with antiphospholipid antibodies and high Factor VIII thrombophilia. A discussion about review and amendment of CMT protocols to include risk stratifying for DVT/ venous thromboembolism (VTE) is required.

References

Mar 31, 2005·The Journal of the American Board of Family Practice·Robert S Bobrow
Sep 14, 2006·Thrombosis Journal·Salwa Khan, Joseph D Dickerman
Apr 2, 2010·American Journal of Preventive Medicine·Michele G BeckmanThomas L Ortel
Oct 6, 2010·Journal of the Royal Army Medical Corps·J Burgess
Jun 29, 2012·BMJ : British Medical Journal·Lee-Yee ChongUNKNOWN Guideline Development Group

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Antiphospholipid Syndrome

Antiphospholipid syndrome or antiphospholipid antibody syndrome (APS or APLS), is an autoimmune, hypercoagulable state caused by the presence of antibodies directed against phospholipids.

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