Survival after cardiac arrest secondary to high-risk pulmonary embolism without reperfusion therapies: A case report

Medicine
Cai-Yun XuKe-Xi Liu

Abstract

High-risk pulmonary embolism (PE) needs reperfusion therapies. However, it is difficult to make medical decisions when thrombolysis is contraindicated, though pulmonary embolectomy and percutaneous catheter-directed treatment (CTD) are recommended for these patients. We reported here a case of high-risk PE patient with cardiac arrest (CA), vertebral compression fracture, as well as scalp and frontal hematoma. The diagnosis of PE was based on computed tomography pulmonary angiography (CTPA) which demonstrated filling defects in the right and left pulmonary arteries. Cardiopulmonary resuscitation was performed until the patient returned to idioventricular rhythm 3 minutes after admitted. She suffered another half-hour of hemodynamic disturbance after her shock improved 3 days later. The diagnosis of PE was confirmed by CTPA at that time. The patient did not receive any reperfusion therapies because hemoglobin decreased significantly. Moreover, anticoagulation was postponed for 2 weeks when bleeding appeared to be stopped. She received overlapping treatment with low molecular weight heparin and warfarin for 5 days then warfarin alone and discharged. She was discharged with normal vital signs and neurologically intact. She received...Continue Reading

References

Jun 13, 1998·The New England Journal of Medicine·D K WysowskiP Botstein
Sep 1, 2014·European Heart Journal·Stavros V KonstantinidesUNKNOWN Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)
Sep 3, 2014·European Heart Journal·Stavros Konstantinides, Adam Torbicki

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