Atypical presentation of pulmonary embolism and deep vein thrombosis due to protein S deficiency in a young female with chest pain

Venous thromboembolism has many risk factors including protein S deficiency, which poses a significant diagnostic challenge as it presents with atypical complaints. A treatable yet potentially fatal condition, acute pulmonary embolism, is currently third most common cause of cardiovascular death. Clinicians should include pulmonary embolism as differential diagnosis in young adults with atypical symptoms with 2 D ECHO findings of the dilated right atrium, right ventricle, and elevated pulmonary artery pressure, and diagnosis is confirmed by computed tomography pulmonary angiography (CTPA). Anticoagulants including NOACs should be initiated promptly to improve the outcome for patients.