heart catheterization showed mild-to-moderate coronary artery disease with LV ejection fraction of 50-55%. The LV end-diastolic pressure was 15 mmHg and mean wedge pressure was 17 mmHg. There was no pulmonary hypertension with mean PA pressure of 17 mmHg consistent with the 2D echo findings. Prominent V waves were detected on wedge pressure tracings. Left ventriculography showed severe mitral regurgitation. Because of his worsening dyspnea on exertion and atrial fibrillation associated with MVP complicated by severe MR with already decompensated LV systolic function, he was referred for MV surgery.

IntroductionSeveral scientific studies support the relation between pulmonary embolism and antipsychotic treatment (acute or chronic). We present a case of possible association of venous thromboembolism (VTE) and ziprasidone.Personal antecedentsMan, 55-year-old, with mild hypertension. He has neither toxics habits nor allergies. He does exercise every day. He started with behavioral and perception disorders during 9 months before being diagnosed of paranoid schizophrenia in 2002. He began with risperidone 3 mg per day and amisulpride 25 mg per day as hypnotic. It allowed a good development and he keeps stable since then. The treatment produced sedation and weight increase, so it was changed to ziprasidone 60 mg per day and later 40 mg per day. A few months ago, he was hospitalized with breathelessness that started suddenly two days before. After all diagnostic tests, he was diagnosed with pulmonary embolism and right leg VTE. His medical development was very positive and he must begin with acenocumarol (doses–depend) and support stockings.ConclusionAs we know, since last 10 years, antipsychotic exposure significantly increases the risk of pulmonary embolism. Due to the lack of risk related factor in this case, it would point that reason. The increase related is about 50% of developing VTE and this increased risk similarly applies to first and second generation antipsychotics drugs. Despite that, there are more cases in olanzapine, clozapine and haloperidol treatments due to antiaggregatory action and antithrombotic effects. We present this case probably closely related with ziprasidone.Disclosure of interestThe authors have not supplied their declaration of competing interest.