Abstract
Background: Coronary heart disease and pulmonary embolism are both thrombotic diseases, and now, patients with coronary heart disease and pulmonary embolism are not uncommon in clinical practice. However, there are some challenges in clinical diagnosis of pulmonary embolism due to their overlapping primary symptoms such as chest tightness and dyspnea. This confluence frequently leads to underdiagnosis or misdiagnosis of pulmonary embolism, thus precipitating treatment delays and compromising patient outcomes. Here we reported a patient who successfully diagnosed with both diseases and ultimately underwent coronary artery bypass grafting, anticoagulant and antiplatelet drug therapy, with a good prognosis.
Case presentation: A 51-year-old male with a history of hypertension for 2 years, came to local hospital due to paroxysmal chest tightness for 1 day and was diagnosed with coronary heart disease, but he refused hospitalizationour. Then, he came to our hospital for treatment due to recurring symptoms. After admission, a comprehensive examination found that D-dimer was elevated, and further computer tomography pulmonary angiography was performed to confirm the diagnosis of pulmonary embolism. This patient finally successfully received coronary artery bypass grafting with anticoagulant and antiplatelet drugs, whose prognosis is good.
Conclusions: This case has guiding significance for the treatment of patients with coronary heart disease combined with pulmonary embolism. Coronary artery bypass grafting combined with anticiagulation and antiplatelet therapy is feasible for such patients. Clinically, when diagnosing coronary heart disease, D-dimer screening should be performed, and if PE is suspected, computer tomography pulmonary angiography should be performed as soon as possible to confirm the diagnosis to decide personalized treatment strategy.