Severe Young Pulmonary Thrombosis in a Mild COVID-19

21 year old second M.B.B.S. medical student admitted in Government College and Hospital with complaints of productive cough since 9 days followed by sudden onset breathlessness since 7 days. Patient received Second dose of Covishield vaccine one month prior to admission. He did not give history of COVID 19 infection in the past but he had exposure to his infected friends. There were no known risk factors. On admission pulse rate was 140/min and blood pressure was 120/70mmhg and Saturation was 90% on room air for which patient started on Oxygen therapy. ECG was suggestive of Sinus tachycardia with S1T3 pattern. D-Dimer was raised markedly i.e. 3360 mg/lit. Bilateral lower limb Doppler study was normal. CT with pulmonary angiography done which suggests Massive pulmonary thromboembolism. 2D-Echo was suggestive of RV dysfunction. Patient thrombolysed with tenectaplase 40mg and is started on heparin and oral anticoagulant therapy and discharged after stabilisation.