Clinical masks of pulmonary embolism: experience of the Regional Vascular Center
DOI: 10.32364/2587-6821-2026-10-9-6
Clinical masks of pulmonary embolism: experience of the Regional Vascular Center
O.S. Lobanova1, S.V. Dudarenko2, I.Z. Gaydukova3,4,5
1 Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russian Federation
2 Nikiforov All-Russian Center of Emergency and Radiation Medicine (NRCERM) of EMERCOM of Russia, St. Petersburg, Russian Federation
3 North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russian Federation
4 V.A. Nasonova St. Petersburg Clinical Rheumatology Hospital, St. Petersburg, Russian Federation
5 Russian University of Medicine, Moscow, Russian Federation
Aim: to systematize the main "clinical masks" of pulmonary embolism (PE) that may complicate timely diagnosis, based on the analysis of clinical case reports at the Regional Vascular Center.
Anamnesis, complaints, physical examination data, electrocardiography, echocardiography, duplex scanning of the lower extremity veins, computed tomography (CT), and laboratory parameters were evaluated in all patients. The diagnosis of PE was confirmed by CT angiography (CTA). In all three cases, the initial diagnosis did not correspond to PE. In a 68-year-old patient with arterial hypertension, PE was masked as acute coronary syndrome (i. e., a "cardiac mask"). As for a 66-year-old patient, a syncopal episode led to suspicious acute cerebrovascular accident, a "cerebral mask". Finally, PE manifested with loss of consciousness and head trauma associated with postoperative hypodynamia which was interpreted as a traumatic brain injury in a 56-year-old female. Thus, as PE often masquerades as other diseases, this requires high clinical vigilance from physicians. Validated scales, D-dimer assay, and CT angiography are key diagnostic elements.
Keywords: PE, pulmonary embolism, clinical masks, diagnosis, D-dimer, CTA.
For citation: Lobanova O.S., Dudarenko S.V., Gaydukova I.Z. Clinical masks of pulmonary embolism: experience of the Regional Vascular Center. Russian Medical Inquiry. 2026;10(9):629–635 (in Russ.). DOI: 10.32364/2587-6821-2026-10-9-6
About the authors:
Olga S. Lobanova — C. Sc. (Med.), Deputy Chief Physician for Medicine, Moscow Regional Research and Clinical Institute ("MONIKI"); 61/2, Shchepkin str., Moscow, 129110, Russian Federation; ORCID iD 0009-0007-3907-7784
Sergey V. Dudarenko — Dr. Sc. (Med.), Professor, Head of the Department of Therapy and Integrative Medicine, Nikiforov All-Russian Center of Emergency and Radiation Medicine (NRCERM) of EMERCOM of Russia, 4/2 lit. A, pom. 1N, Akademika Lebedeva Str., St. Petersburg, 194044, Russian Federation. ORCID iD 0000-0001-7278-6418
Inna Z. Gaydukova — Dr. Sc. (Med.), Professor of E.E. Eichwald Department of Therapy and Rheumatology; 41, Kirochnaya str., St. Petersburg, 191015, Russian Federation; Board-Certified Rheumatologist, V.A. Nasonova St. Petersburg Clinical Rheumatology Hospital; 30, Bolshaya Podyacheskaya str., St. Petersburg, 190068, Russian Federation; Head of the Department of Rheumatology, Faculty of General Medicine, N.A. Semashko Institute of Clinical Medicine, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; ORCID iD 0000-0003-3500-7256
Contact information: Olga S. Lobanova, e-mail: dcgb1_lobanova@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 20.06.2026.
Revised 14.07.2026.
Accepted 06.08.2026.
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