{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T08:05:24Z","timestamp":1759565124929},"reference-count":16,"publisher":"California Digital Library (CDL)","issue":"3","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>A healthy 18-year-old male presented to the emergency department with chest pain, palpitations, and dyspnea. His exam was unremarkable; however, point-of-care ultrasound (POCUS) revealed right ventricular strain with a D-sign and enlarged right ventricle. He subsequently reported a history of factor V Leiden. His D-dimer was markedly elevated, and a computed tomography angiogram of the chest demonstrated submassive pulmonary embolism (PE). He was taken to the catheterization lab for directed thrombolysis and was discharged in good condition two days later. Factor V Leiden is the most common genetic cause of venous thromboembolism. POCUS can facilitate rapid diagnosis and risk stratification of patients with acute PE.<\/jats:p>","DOI":"10.5811\/cpcem.2018.9.39218","type":"journal-article","created":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T01:32:05Z","timestamp":1564623125000},"page":"271-274","source":"Crossref","is-referenced-by-count":2,"title":["Dyspnea in an Otherwise Healthy 18-year-old: The Importance of Point-of-care Ultrasonography"],"prefix":"10.5811","volume":"3","author":[{"given":"Emily","family":"Cleveland Manchanda","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigmund","family":"Kharasch","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Liteplo","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2019,7,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Theodoro D, Blaivas M, Duggal S, et al. 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Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J. 2008;29(18):2276-315.","DOI":"10.3410\/f.1141915.599023"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Meyer G, Vicaut E, Danays T, et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med. 2014;370(15):1402-11.","DOI":"10.1056\/NEJMoa1302097"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Ryu JH, Pellikka PA, Froehling DA, et al. Saddle pulmonary embolism diagnosed by CT angiography: frequency, clinical features and outcome. Respir Med. 2007;101(7):1537-42.","DOI":"10.1016\/j.rmed.2006.12.010"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Sardi A, Gluskin J, Guttentag A, et al. Saddle pulmonary embolism: is it as bad as it looks? A community hospital experience. Crit Care Med. 2011;39(11):2413-8.","DOI":"10.1097\/ccm.0b013e31822571b2"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Zarghouni M, Charles HW, Maldonado TS, et al. Catheter-directed interventions for pulmonary embolism. Cardiovasc Diagn Ther. 2016;6(6):651-61.","DOI":"10.21037\/cdt.2016.11.15"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Kucher N, Boekstegers P, M\u00fcller O, et al. Randomized controlled trial of ultrasound-assisted catheter-directed thrombolysis for acute intermediate-risk pulmonary embolism. 2013. Available at: http:\/\/circ.ahajournals.org\/content\/early\/2013\/11\/13\/CIRCULATIONAHA.113.005544.short. Accessed August 17, 2017.","DOI":"10.1161\/circulationaha.113.005544"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Kujovich JL. Factor V Leiden thrombophilia. 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