Is it always anterior chest pain angina pectoris?

Acute pulmonary embolism (PE) still remains a difficult diagnosis because of its chameleonic clinical presentation. Although it is a common clinical scenario, PE is frequently underdiagnosed. We report a case of acute PE that highlights the importance of a diagnostic strategy based on clinical probability assessed by a validated prediction rule. Our report is also highly suggestive for the importance of computed tomographic angiography, the most useful imaging method that provide direct signs for diagnosis and also significant information on alternative clinical conditions. A useful conclusion for clinical practice is that any data must be rationally judged, considering the limits of clinical diagnosis and laboratory tests. Keywords: pulmonary embolism, angina pectoris, computed tomographic angiography