Unrecognized Post-Traumatic Stress Disorder as the Lingering Shadow of Pulmonary Embolism

JACC Case Rep. 2026 Nov 5:111086. doi: 10.1016/j.jaccas.2026.111086. Online ahead of print.

ABSTRACT

BACKGROUND: Thromboneurosis, though not a formally recognized diagnostic entity, describes the chronic anxiety, hypervigilance, and fear of recurrence that can follow venous thromboembolism, an under-recognized and underdiagnosed complication of pulmonary embolism (PE). Despite growing literature on its prevalence, no comprehensive, venous thromboembolism-specific psychological screening instrument, standardized diagnostic pathway, or guideline-endorsed management strategy currently exists. Consequently, cases often remain undiagnosed until significant quality-of-life decline occurs.

CASE SUMMARY: We report a 43-year-old man who, after appropriate treatment for intermediate-risk (Category C2) PE, presented to the emergency department 5 separate times with recurrent chest pain, dyspnea, and palpitations. He was subsequently diagnosed with thromboneurosis/post-PE post-traumatic stress disorder.

DISCUSSION: This case highlights the substantial clinical and health care burden associated with delayed recognition of the psychological effects of post-PE and supports routine integration of structured psychological screening into multidisciplinary post-PE follow-up pathways.

TAKE-HOME MESSAGE: Structured psychological screening should be integrated into multidisciplinary post-PE follow-up to reduce diagnostic delay and unnecessary acute care utilization.

PMID:42986277 | DOI:10.1016/j.jaccas.2026.111086