Massive pulmonary embolism masked as an episode of acute agitation in a psychiatric patient: a case report

Abstract

Management of the psychiatric diseases’ reacutization is a frequent occurrence in emergency medicine. During this COVID-19 pandemic, a further increase in access to the emergency room was reported, and the reasons are numerous. Although the essential prerogative of the emergency department is to provide immediate clinical assistance by rapidly setting an effective diagnostic and therapeutic path, there are multiple obstacles to providing adequate care for Emergency Department patients with mental illness. In this report, we describe the case of a 65-year-old female patient with severe schizophrenia who was evaluated in the emergency room for acute agitation masking a subtle persistent dyspnea. The possibility of an underlying medical cause should not be underestimated or completely forgotten due to the difficult approach to the psychiatric patient.