“Chest pain mimicking pulmonary embolism may be a common presentation of COVID-19 in ambulant patients without other typical features of infection”

This study aimed to analyze whether focal pulmonary changes due to Covid-19 presenting with chest pain mimic pulmonary embolism in mild disease. Patients presenting with chest pain mimicking pulmonary embolism underwent CT pulmonary angiograms. This study focused on patients with mild disease and chest pain being the only presenting symptom.

The study was a retrospective cohort of outpatient records of clinically stable patients presenting with chest pain, who underwent CTPA due to PE being suspected as most likely diagnosis. The study found that 32.8% of patients had pulmonary parenchymal changes characteristic of Covid-19 or viral infection with most patients not having typical Covid-19 symptoms with the exception of dry cough. All patient presented with chest pain that was more typical of PE, not PNA. The article concluded that chest pain typical of PE may be the only presenting symptom in mild Covid-19 disease.

The study acknowledged limitations such as small sample size and reliance on antibody testing for confirmation of Covid-19 infection. Many patients were presumed to be Covid-19 positive based on typical Covid-19 CTPA findings.

This article pertained to the patient in H&P 1 as the patient presented with pleuritic chest pain, headache, and dry cough. The patient did not give the impression of Covid-19 but was tested due to high prevalence of the virus. Outside of the pandemic, this patient would’ve probably warranted transport to ED for PE r/o with CTA as all other diagnoses would’ve been ruled out at the urgent care.