Pulmonary embolism (PE) should be strongly considered in patients presenting with refractory hypoxemia and dyspnea, even in the absence of clinical signs of deep vein thrombosis (DVT).

This study highlights the importance of maintaining a high index of suspicion in such cases, as timely diagnosis is critical for effective treatment.

Computed tomography pulmonary angiography (CTPA) remains the gold standard for diagnosing PE, and its use is essential in identifying the condition in patients with unexplained hypoxemia.

Doppler ultrasound, though typically used to detect DVT, is also valuable in these cases, as it can uncover subclinical DVT in a significant proportion of patients.

A retrospective analysis was performed on 20 patients admitted to a tertiary care hospital with refractory hypoxemia and dyspnea between January 2022 and September 2024.

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