The Triple Threat in Practice: A Case Study of Stroke and Pulmonary Embolism in a Diabetic Patient Triple Threat in Diabetic Patient

Resumen

Diabetes mellitus is a well-established risk factor for both arterial and venous thromboembolic events due to its adverse effects on vascular function and blood clotting mechanisms. This case report presents a 54-year-old female diabetic patient who was admitted with severe hyperglycemia and diabetic ketoacidosis. Shortly after stabilization, the patient experienced sudden left sided hemiplegia, suggestive of an ischemic stroke. Despite prompt antiplatelet treatment and supportive care, patient had acute dyspnea and increased D-dimer levels resulting in a diagnosis of saddle pulmonary embolism. Prompt identification and treatment with anticoagulation (heparin shifted to rivaroxaban) let to marked improvements in both respiratory and neurological symptoms. This case highlights the “triple threat” and the complex pathophysiological interaction between diabetes, ischemic stroke and thromboembolic complications. The metabolic abnormalities associated with diabetes are likely contributed to a hypercoagulable state, which could further exacerbate the prothrombotic state.