Pulmonary Embolus— Unusual Presentations and Diagnostic Dilemma

To the Editor:

Thank you for your report of a pulmonary embolism case in the October 2008 issue of Clinical Geriatrics.1 I’ll bet we are all missing lots of pulmonary emboli (PEs). I wonder what to do with all of my patients who are immobilized from old strokes or multiple sclerosis. Should they be on prophylactic anticoagulation chronically? I’ll keep your case in mind. You also taught me about McConnell’s sign. If the case patient didn’t have contraindications, I’m sure she may have been offered tissue plasminogen activator because of this sign, despite her norma...