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A 21- year old single Caucasian female.

Family history:
Both parents are healthy.

Personal history:
She has been healthy until now, without any prior surgery.
       She had an appendectomy 5 days ago. On the fifth day after surgery she was discharged from hospital. Upon arrival home when taking a shower she had a short episode of dyspnea and dizziness. She was currently on no medication except for contraceptives. With the above mentioned symptoms she presented at the emergency room.

Physical examination:
She had no dyspnea at rest, but she became short of breath while taking a seat. Body temperature was normal, she was normosthenic, blood pressure 100/60, heart rate 100/min, breathing rate 15/min, weight 55 kg. Other physical examination was completely normal, no swelling of legs. The operation wound was healed.

Examinations:
A. ECG: sinus tachycardia, iRBBB.
B. X-ray examination of the lungs and the heart without any pathological findings.
C. Venous ultrasound did not detect thrombus.
D. Perfusion lung scanning revealed diminished perfusion in the both sites.
E. pH = 7.38, pO₂ = 7.2 kPa, pC0₂ = 3.6 kPa.
F. Blood cell count: Leu = 10x10⁹/l, Ery = 4.3 x 10¹²/l , Hb = 120 g/l, Htk = 0.40, Plt = 323 x 10⁹/l.
G. APTT control plasma = 34.1 s, patient plasma = 35.1 s.
H. INR = 1.1.
CH. D-fibrinogen dimer = 2000 mg/ml.