A Case of Pulmonary Embolism on Computed Tomography With Negative D-Dimer and Elevated Troponins

We present the case of an obese 35-year-old man who had been seeing his local primary care provider for shortness of breath over a couple of months. He reported that most of his shortness of breath occurred during exertion and would subside with rest. He was treated for anxiety and what was thought to be reactive airway disease. He was evaluated in the local emergency room for acute shortness of breath and midsternal chest pain. The initial diagnosis was pulmonary embolism with subsegmental and segmental pulmonary emboli. D-dimer was within normal range, and bilateral lower extremity ultrasound was negative for deep vein thrombosis.