Short-Haul Flight: Is it a Risk to Pulmonary Embolus?

Abstract

Introduction Pulmonary thromboembolism (PTE) still remains a diagnostic challenge to junior doctors working in emergency departments. Being aware of the condition and its associated risk factors can improve the diagnostic accuracy. Association between passenger travelling long-haul flight and PTE has been well documented; however its association with short-haul flight is very rare and controversial. This case report illustrates the possible linkages between short-haul air travel with the development of classic non-fatal PTE. Clinical feature A young Indian gentleman after travelling four hours on a flight complained of progressive worsening of breathlessness when he arrived at Kuala Lumpur. Clinically he was tachypnoeic and tachycardiac. The electrocardiogram showed T inversion in leads III and aVF, and S wave in lead I. Oligaemia was shown on the chest X-ray and hypoperfused areas were seen on the spiral computed tomographic angiogram. Treatment He was started on unfractionated heparin, switched to low molecular weight heparin, and then warfarin and subsequently admitted to the coronary care unit. Outcome He was discharged well on day 7 after admission with warfarin and medical advice before returning to India. Conclusion Non-fatal PTE is at times difficult to diagnose and requires a high index of suspicion. Its association with healthy passengers of short-haul flight is not well established and this case report illustrates the possibility of linkages.