• Lisa Mehl, Johanna Donner, and Guntram Lock.
• Klinik für Innere Medizin, Albertinen-Krankenhaus Hamburg.
• Dtsch. Med. Wochenschr. 2020 Nov 1; 145 (23): 1697-1700.

HistoryA 39-year-old woman with suddenly occurring exercise dyspnea is admitted under the suspicion of pulmonary embolism. In medical history, she mentions a recently completed fertility treatment.Findings And DiagnosisClinically, the patient is in good condition. D-dimers and hCG are markedly elevated. Sonography reveals pronounced ascites, a large right-sided pleural effusion and multicystic, clearly enlarged ovaries. In conjunction with medical history and confirmed by the gynecologists, the diagnosis of ovarian hyperstimulation syndrome (OHSS) is made, classified as grade II-III (moderate to severe).Therapy And CourseThrombembolic prophylaxis with Certoparin 3000 IU/d is established as sole therapy. The course of the disease is self-limited.ConclusionOHSS is primarily a gynaecological condition, but physicians may encounter it with exercise dyspnea or abdominal pain as presenting symptoms. Symptoms can be treated well at an early stage, and severe courses can usually be prevented. In this case, clinical history and sonography could disprove the initially suspected diagnosis of pulmonary embolism.Thieme. All rights reserved.

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