Timofeeva N.Yu. , Stomenskaya I.S., Kostrova O.Yu.
Challenges in diagnosing pulmonary embolism (a clinical case from the practice of a general practitioner)
Keywords: pulmonary embolism, arterial hypotension, rheumatoid arthritis, methotrexate, methylenetetrahydrofolate reductase mutation, computed angiography, echocardiography, ultrasound Dopplerography of the veins of the lower extremities
One of the most life-threatening conditions in the structure of cardiovascular pathology is pulmonary embolism. Its most common cause is deep vein thrombosis of the lower extremities. Chronic inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus, and taking anti-inflammatory drugs (methotrexate, prednisone) increase the risk of thromboembolic complications. Pulmonary embolism is one of the most difficult nosologies in terms of diagnosis due to frequent nonspecific clinical presentation and the absence of pathognomonic symptoms. High-tech examination methods such as computed angiography and echocardiography are needed to diagnose pulmonary embolism. However, these methods are not available in every medical institution, especially around the clock. The article describes a clinical case of pulmonary embolism. The background for its development was a long history of rheumatoid arthritis, taking methotrexate and prednisone, as well as a homozygous mutation of methylenetetrahydrofolate reductase. The difficulty of diagnosis was associated with nonspecific clinical presentation and the absence of characteristic signs of pulmonary embolism. Only computer angiography and echocardiography gave the opportunity to make a correct diagnosis and administer appropriate treatment.
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About authors
- Timofeeva Natalya Yu.
- Candidate of Medical Sciences, Associate Professor, Department of Faculty Therapy, Chuvash State University, Russia, Cheboksary (bla11blabla@yandex.ru; ORCID: https://orcid.org/0000-0002-7596-0132)
- Stomenskaya Irina S.
- Candidate of Medical Sciences, Associate Professor, Department of Faculty Therapy, Chuvash State University, Russia, Cheboksary (irina.stomenskaja@gmail.com; ORCID: https://orcid.org/0000-0001-7332-4477)
- Kostrova Olga Yu.
- Candidate of Medical Sciences, Associate Professor, Department of Faculty Therapy, Chuvash State University, Russia, Cheboksary (evkbiz@yandex.ru; ORCID: https://orcid.org/0000-0002-7057-9834)
Article link
Timofeeva N.Yu. , Stomenskaya I.S., Kostrova O.Yu. Challenges in diagnosing pulmonary embolism (a clinical case from the practice of a general practitioner) [Electronic resource] // Acta medica Eurasica. – 2026. – №3. P. 62-69. – URL: https://acta-medica-eurasica.ru/en/single/2026/3/8/. DOI: 10.47026/2413-4864-2026-3-62-69.
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