Acute pulmonary embolism and deep vein thrombosis due to protein S deficiency in a young female presenting with chest pain

Protein S deficiency is a major risk factor for venous thromboembolism, posing a diagnostic challenge due to atypical presenting complaints.Acute pulmonary embolism is a common, treatable but potentially fatal condition, currently third most common cause of cardiovascular death.It is important for physicians to consider pulmonary embolism as a differential diagnosis in young adults presenting atypical symptoms with dilated right atrium, right ventricle and elevated pulmonary artery pressure on echocardiography.Computed tomography pulmonary angiography (CTPA) confirms pulmonary artery thrombosis.Prompt management with anticoagulant should be done to improve the outcome of patients.