Hiccups as a rare presentation of pulmonary embolism: A case report study

Pulmonary Embolism (PE) causes more than 300,000 deaths per year in the United States. Early diagnosis and treatment can significantly reduce mortality. Hiccups are involuntary spasmodic contractions in the respiratory muscles (inspiratory muscles), especially the diaphragm. Due to the importance of early diagnosis and quick treatment of PE, knowing its uncommon symptoms can help to diagnose and treat it before death. A 67-year-old man with no history of previous diseases and a history of knee joint surgery (5 years ago) came to the emergency room (ER) with continuous hiccups since 10 days ago. There were no cardiovascular risk factors such as family history, history of stroke and thromboembolism, smoking, alcohol, diabetes mellitus and hypertension. Respiratory rate (RR) was 18 breaths/minute, pulse rate (PR) was 120 beats/minute, blood pressure (BP) was 122/84 mmHg, oxygen saturation (SPO2) in the room was 96%, and body temperature (T) was 36 °C. He was a candidate for computed tomography angiography (CTA). The filling defect was observed in the distal peripheral of the left main pulmonary artery (LMPA), with extension to the left upper lobe (LUL), left lower lobe (LLL), and segmental branches. After 6 days of hospitalization, with the improvement of symptoms and stability of vital signs, he was discharged with medications. Due to the association of hiccups with dangerous diseases, it is important to investigate continuous and long hiccups.