When Clotting and Bleeding Collide: A Case of Bilateral PE and Concurrent Upper GI Hemorrhage

Abstract

Introduction Concurrent episodes of pulmonary emboli and gastrointestinal bleeding in one patient are not commonly seen. When a patient presents with both, it presents a challenge to manage as they are opposite ends of the same disease spectrum associated with the coagulation system. Case Report We present the case of a 65-year-old male who presented to our hospital via EMS with unknown prior history after a witnessed cardiac arrest, who on evaluation also had a concurrent bilateral pulmonary emboli with right heart strain. Why should an emergency physician be aware of this? While there is extensive research on the management of a PE and upper GI bleeding, there is limited data on concurrent management of both conditions. This case serves to explore the clinical dilemmas related to the management of patients with coexisting PE and an upper GI bleed