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Author Notes:

Temidayo Abe, MD, Internal Medicine Residency Program, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA 30310, USA. Email: tabe@msm.edu

Phani Keerthi Surapaneni and Temidayo Abe equally contributed to this case report and are both first authors.

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.


Research Funding:

The author(s) received no financial support for the research, authorship, and/or publication of this article.


  • V/Q scan
  • cocaine
  • pulmonary embolism

Cocaine-Induced Ventilation/Perfusion Mismatch Mimicking Pulmonary Embolism


Journal Title:

Journal of Investigative Medicine High Impact Case Reports


Volume 8


, Pages 2324709620906962-2324709620906962

Type of Work:

Article | Final Publisher PDF


Pulmonary complications from cocaine use can range from bronchospasm to vasospasm leading to pulmonary infarction. Profound vasospasm may also lead to perfusion defects presenting as pulmonary embolism on ventilation-perfusion scan. A 65-year-old patient with a past medical history of substance abuse and chronic kidney disease presents to the emergency department with sudden-onset chest pain and shortness of breath. Ventilation-perfusion scan revealed filling defect most notably in the lingual lobe. He was later discharged on warfarin for the management of pulmonary embolism. The patient presented to the emergency department 2 weeks later with similar complaints; the international normalized ratio was subtherapeutic, and urine drug screen was positive for cocaine. Repeat ventilation-perfusion scan revealed no filling defects. Follow-up bilateral venous Doppler of lower extremities and D-dimer were within normal limits.

Copyright information:

© 2020 American Federation for Medical Research.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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