Suspected Pulmonary Embolism-Associated Advanced Heart Block

We describe a 35-year-old Caribbean-Black male smoker with suspected pulmonary embolism (PE)-associated advanced heart block, which was both confirmed with computed tomography pulmonary angiography (CTPA) and inpatient telemetry. The patient received guideline-directed medical therapy for PE, including direct oral anticoagulation (DOAC), and underwent permanent dual-chamber pacemaker (DCPM) implantation for complete heart block (CHB). The clinician should consider atypical etiologies such as PE in young adults presenting with advanced heart block.