Massive pulmonary thromboembolism treated successfully with streptokinase. Report of one case

Massive pulmonary thromboembolism has a high mortality. Early thrombolysis is the treatment of choice. We report a 79-year-old man admitted in shock. A chest angio-CAT scan showed a massive pulmonary thromboembolism. A transthoracic echocardiography showed a right cardiac dysfunction. Although the p...

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Bibliographic Details
Published in:Revista medíca de Chile 2010-07, Vol.138 (7), p.856
Main Authors: Leal, José Luis, Lora, Pilar, Enciso, Giovanni, Reynolds, Enrique
Format: Article
Language:Spanish
Subjects:
Aged
Fibrinolytic Agents - therapeutic use
Humans
Male
Pulmonary Embolism - diagnosis
Pulmonary Embolism - drug therapy
Streptokinase - therapeutic use
Tomography, X-Ray Computed
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Summary:Massive pulmonary thromboembolism has a high mortality. Early thrombolysis is the treatment of choice. We report a 79-year-old man admitted in shock. A chest angio-CAT scan showed a massive pulmonary thromboembolism. A transthoracic echocardiography showed a right cardiac dysfunction. Although the patient was in hemodynamic instability, he was subjected to thrombolysis with streptokinase, assisted with noradrenaline support and invasive mechanical ventilation. Parenteral anticoagulation was started thereafter. A second echocardiography, performed 72 hours later showed an improvement in right ventricular function. The patient had a nosocomial pneumonia that was treated. Noradrenalin and mechanical ventilation were discontinued nine and 15 days after thrombolysis. A new angio-CAT scan, 23 days after the procedure, was normal. The patient was discharged in good conditions 27 days after admission.
ISSN:0034-9887