Analysis of Delayed Diagnosis and Treatment of Msucular Calf Vein Thrombosis with Acute Pulmonary Thromboembolism

JIA Weihong; WANG Lina; JIANG Yangyang; YANG Dongcai; BO Lina; LIU Zhiyan; LIU Ya-dong; TANG Jingjing

doi:10.3969/j.issn.1002-3429.2025.05.004

Abstract：Objective To investigate the clinical characteristics of muscular calf vein thrombosis(MCVT)complicat-ed with acute pulmonary thromboembolism(APTE),so as to avoid the delay in diagnosis and treatment.Methods The clin-ical data of 7 patients with MCVT and APTE treated from January 2019 to December 2023 were retrospectively analyzed.Re-sults Among the 7 patients,there were 3 males and 4 females aged ≥60 years,and all patients were misdiagnosed.Clinical manifestations revealed fever in l patient,syncope in 1 patient,shortness of breath in 6 patients,and chest tightness in 6 pa-tients.D-dimer and fibrin degradation products were increased in 7 patients.The sites of MCVT were bilateral in 2 patients,left in 4 patients and right in 1 patient.Site of pulmonary thromboembolism included bilateral main pulmonary artery in 2 pa-tients,right pulmonary artery in 3 patients,and left pulmonary artery in 2 patients.All 7 patients had multiple pulmonary em-bolism.The patients were misdiagnosed with acute coronary syndrome in 2 patients and pulmonary infection in 5 patients,and the misdiagnosis lasted 7d-3 months.Seven patients were treated with anticoagulant therapy with Rivaroxaban,1 patient had recurred pulmonary thromboembolism after withdrawal of anticoagulant therapy,and was treated with anticoagulant therapy,and the remaining 6 patients were cured.Conclusion The early symptoms of MCVT complicated with APTE are mild and more likely to be missed.We need to improve the understanding of this complication.Patients with MCVT who have sudden chest tightness,shortness of breath and syncope,especially those with a history of tumor and atrial fibrillation,should be highly suspected of the possibility of developing pulmonary thromboembolism.