2012, Number 2
Accute pulmonary embolism clinical case
Full text
Language: English
References: 12
Page: 72-77
PDF size: 391.51 Kb.
ABSTRACT
This is a case of a patient in his seventies that during exercise presents acute dyspnea and blackout for 10 minutes, he visits the physician who diagnosis a probable Acute Coronary Syndrome and sends him to our hospital. At the Emergency Room (ER), after an echo cardiogram, laboratory exams and an electrocardiogram the patient was diagnosed with an acute pulmonary embolism and was sent to the Intensive Care Unit (ICU). He was stable and medicated with Heparin, after a CT Pulmonary Angiography (CTPA) he was treated with Tenecteplase and eight days later he was discharged in good health working conditions.REFERENCES
Torbicki A., Perrier A., Konstantinides S., Agnelli G., Galiè N., Pruszczyk P., Bengel F., Brady A. J .B., Ferreira D., Janssens U., Klepetko W., Mayer E., Remy-Jardin M., Bassand J. P. Guías de práctica clínica de la Sociedad Europea de Cardiología. Guías de práctica clínica sobre diagnóstico y manejo del tromboembolismo pulmonar agudo. Rev Esp Cardiol. 2008;61(12):1330.
Torbicki A., Perrier A., Konstantinides S., Agnelli G., Galie N., Pruszczyk P., Bengel F., Brady A. J. B., Ferreira D., Janssens U., Klepetko W., Mayer E., Remy-Jardin M., Bassand J. P. Guidelines on the diagnosis and management of acute pulmonary embolism. European Heart Journal (2008) 29, 2276-2315 doi:10.1093/eurheartj/ehn310.
Stein P. D., Woodard P. K., Weg J. G., Wakefield T. W., Tapson V. F., Sostman H. D., Thomas A. S, Quinn D. A., Leeper K. V., Hull R. D., Hales C. A., Gottschalk A., Goodman L. R., Fowler S. E., Buckley J. D. Diagnostic Pathways in Acute Pulmonary Embolism: Posterior wall 10mm Tricuspid S wave 11 cm/s Isovolumetric relaxation 116 Left heart Right heart Diastolic function LVEF66% Left auricle 42mm Right Auricle 42mm E wave 69 FAC 36% Diastolic diameter 45mm Right ventricle 30 mm A wave 89 Final systolic volume 31 ml Diameter systolic 26mm Pulmonary systolic pressure 65mm Relationship E/A 0.8 Septum 11mm Systolic displacement of the tricuspid ring 24mm Mitral deceleration 201 Table 2. Echo cardiogram taken on the September 25th, 2012. Recommendations of The PIOPED II Investigators. The American Journal of Medicine (2006) 119, 1048-1055.
Stein P. D., Fowler S. E., Goodman L. R., Gottschalk A., Hales C. A., Hull R. D., Leeper K. V., Popovich J., Quinn D. A., Sos T. A., Sostman H. D., Tapson V. F., Wakefield T. W., Weg J. G., Woodard P. K. Multidetector Computed Tomography for Acute Pulmonary Embolism. N Engl J Med 2006;354:2317-27. Copyright © 2006 Massachusetts Medical Society.
Masotti L., Righini M., Vuilleumier N., Antonelli F., Cappelli G. L. R., Ray P. Prognostic stratification of acute pulmonary embolism: Focus on clinical aspects, imaging, and biomarkers. Vascular Health and Risk Management 2009:5 567-575 ,© 2009 Masotti et al, publisher and licensee Dove Medical Press Ltd.