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

ABSTRACT 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 instabil...

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Main Authors: Nuria Rodríguez‐Núñez, Alejandra Virgós‐Pedreira, Alfonso Illade‐Fornos, Lucía Ferreiro‐ Fernández, María E. Toubes‐Navarro, Luis Valdés‐Cuadrado
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Respirology Case Reports
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Online Access:https://doi.org/10.1002/rcr2.70098
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Summary:ABSTRACT 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.
ISSN:2051-3380