The Great Masquerader Presenting as Supraventricular Tachycardia in Pott’s Spine: Missed Clue in Pulmonary Embolism

Abstract Pulmonary embolism (PE) is a life-threatening condition that requires prompt diagnosis and intervention. This report describes the case of a 29-year-old female with Pott’s spine who presented for decompressive laminectomy and experienced an atypical intraoperative onset of supraventricular tachycardia (SVT), hypotension, and hypoxemia. Initial management with adenosine and cardioversion restored the sinus rhythm, but subsequent investigations revealed findings suggestive of massive PE, including elevated D-dimer levels and right ventricular dysfunction on echocardiography. Definitive confirmation through computed tomography pulmonary angiography was precluded by the patient’s hemodynamic instability. Despite intensive care management, the patient succumbed to recurrent SVT and cardiac arrest. This case highlights the diagnostic and therapeutic challenges posed by atypical presentations of PE, such as SVT, and underscores the importance of maintaining a high index of suspicion in at-risk populations. Timely diagnosis and treatment remain crucial for reducing mortality in such critical scenarios.