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A Silent Saddle Embolism: Syncope Without Dyspnea or Chest Pain

Year: 2025

Type: article

Abstract: Pulmonary embolism (PE) is a potentially fatal diagnosis that may present without classic symptoms. We describe a rare presentation of a submassive saddle PE manifesting solely as syncope, without dyspnea or chest pain. The patient was found to have significant right ventricular dysfunction and myocardial injury with elevated troponin and was ultimately diagnosed with a large saddle PE and successfully treated with catheter-directed thrombectomy and anticoagulation. This case underscores the importance of echocardiographic RV assessment and early imaging in syncope workup to avoid delayed or missed PE diagnoses.

Source: Cureus

DOI: 10.7759/cureus.94747

Authors: Sheel Vaniawala, Racquille Reid, Nikhil Sikha, Anita Sikha

Institutions: Holy Cross Hospital, University of Miami Hospital, Trinity Health Oakland Hospital, University of Miami

Language: English

Topic: Venous Thromboembolism Diagnosis and Management

Subfield: Internal Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4415254353