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Syncope as the Clinical Presentation of Pulmonary Thromboembolism

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Pulmonary thromboembolism (PTE) has a wide spectrum of presentations, and its cardinal manifestations include chest pain, dyspnea, and syncope. Syncope as an initial presentation of PTE occurs in 10-14% of patients and is not restricted to massive PTEs. It can also occur in the setting of non- massive cases probably due to a vasovagal mechanism or the occurrence of conduction disturbances in preexisting complete left bundle-branch block. The next point discussed here is the use of thrombolytic therapy for submassive PTE with a normal blood pressure while marked right ventricular dyskinesia or dysfunction occurs.

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