A Rare Cause of Acute Dyspnea in the Emergency Department: Pulmonary Cement Embolism

We describe an elderly man who presented to the Emergency Department with dyspnoea induced by a pulmonary cement embolism following vertebroplasty. The diagnosis was made by chest x-ray. Treatment consisted of anticoagulation with heparin. The dyspnea resolved after 7 days, with no sequelae. Vertebroplasty, used for the treatment of osteoporotic fractures in addition to hemangiomas and malignant tumors, may in rare cases be complicated by symptomatic, occasionally life-threatening, cement leakage into the paravertebral venous plexus. It is important that clinicians be alerted to this new emergency medical entity because, owing to the radio-opacity of the cement, it can be diagnosed rapidly on x-ray film if the physician knows what to look for. Though the value of preventive anticoagulation therapy is not proven in this setting, we recommend its use for 6 months, until the embolized material is endothelialized.