Syncope Caused by Pulmonary Embolism after Lung Resection-A Case Report

Pulmonary embolism (PE) after lung resection is a rare occurrence in Taiwan. It is associated with a high mortality rate, but the diagnosis is difficult because the symptoms and signs can be confused with those commonly seen after lung resection. We report a patient who developed PE after lung resection. Syncope was the first presenting symptom. Coagulation screening showed elevated levels of D-dimer. Diagnosis of PE was confirmed by ventilation/perfusion (V/Q) scan and high-resolution computed tomography (HRCT). The patient recovered well with anticoagulant treatment and oxygen support, and was discharged after 19 days. HRCT scan at the 6-month follow-up revealed no filling defect in the pulmonary artery. We reviewed the literature on the risk factors, prophylaxis, treatment and diagnosis of PE. Reports showed that D-dimer seems to be useful in screening. Although the incidence of PE after surgery is lower in ethnic Chinese populations, we should keep this uncommon disease in mind and manage the patients carefully.