Pulmonary Thromboembolism Superimposed on Obstructive Sleep Apnea A Case Report

Non-invasive ventilation with continuous positive airway pressure is gaining popularity as a technique for achieving effective treatment in obstructive sleep apnea. However, we observed a patient at our institution complaining of dyspnea on exertion who was diagnosed with pulmonary embolism even after implementation of continuous positive airway pressure for 5 years. This is a worrying problem because obstructive sleep apnea is known to be a risk for cardiovascular complications, and treatment by the mainstay therapy with continuous positive airway pressure didn't seem to eliminate the fatal complication of pulmonary embolism. The association of pathophysiology between obstructive sleep apnea and pulmonary embolism is uncertain; nevertheless, close monitoring is vital to exclude a pathological and fatal event such as pulmonary embolism even after implementation of continuous positive airway pressure. ( J Intern Med Taiwan 2007; 18: 350355 )