Importance of the Study of the Right Heart Chambers in Symptomatic Acute Pulmonary Embolism

We present the case of a 42-year-old woman on oral contraceptives that presented to the emergency department with pain and swelling in the left lower limb. Diagnosis of extensive deep vein thrombosis was established. A few minutes later, she exhibited signs of shock and hemodynamic instability, thus...

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Detalles Bibliográficos
Autores: Rodríguez Núñez, Nuria, Virgós-Pedreira, Alejandra, Illade-Fornos, Alfonso, Ferreiro Fernández, Lucía, Toubes Navarro, María Elena, Valdés Cuadrado, Luis
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universidad de Santiago de Compostela (USC)
Repositorio:Minerva. Repositorio Institucional de la Universidad de Santiago de Compostela
Idioma:inglés
OAI Identifier:oai:minerva.usc.gal:10347/45714
Acceso en línea:https://hdl.handle.net/10347/45714
Access Level:acceso abierto
Palabra clave:Hemodynamic instability
Pulmonary embolism
Transthoracic echocardiography
Descripción
Sumario:We present the case of a 42-year-old woman on oral contraceptives that presented to the emergency department with pain and swelling in the left lower limb. Diagnosis of extensive deep vein thrombosis was established. A few minutes later, she exhibited signs of shock and hemodynamic instability, thus raising suspicion of high-risk acute pulmonary thromboembolism. Prior to the administration of fibrinolytic treatment, a bedside transthoracic echocardiography was performed that excluded right ventricular dilatation. Then, the study was complemented with a thoraco-abdominal computed tomography scan that demonstrated a large retroperitoneal hematoma as the cause of the shock. In conclusion, a transthoracic echocardiography should be performed before initiating thrombolytic therapy in hemodynamically instable patients with strong suspicion of high-risk pulmonary embolism.