scholarly journals The use of transthoracic echocardiography to guide thrombolytic therapy during cardiac arrest due to massive pulmonary embolism

2002 ◽  
Vol 19 (2) ◽  
pp. 178-179 ◽  
Author(s):  
P MacCarthy
Keyword(s):  
Pulmonary Embolism ◽  
Cardiac Arrest ◽  
Thrombolytic Therapy ◽  
Transthoracic Echocardiography ◽  
Massive Pulmonary Embolism

Transthoracic echocardiography in non-arrhythmogenic cardiac arrest due to massive pulmonary embolism

Resuscitation ◽  
2010 ◽  
Vol 81 (2) ◽  
pp. S79
Author(s):  
M.V. Bertone ◽  
F. Parramon ◽  
S. Arias ◽  
R. García ◽  
B. Pardina ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cardiac Arrest ◽  
Transthoracic Echocardiography ◽  
Massive Pulmonary Embolism

scholarly journals Alteplase for Massive Pulmonary Embolism after Complicated Pericardiocentesis

2019 ◽  
Author(s):  
Ricardo Cleto Marinho ◽  
José Luis Martins ◽  
Susana Costa ◽  
Rui Baptista ◽  
Lino Gonçalves ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Pericardial Effusion ◽  
Thrombolytic Therapy ◽  
Cardiac Tamponade ◽  
Massive Pulmonary Embolism ◽  
Extensive Study ◽  
Life Saving ◽  
Obstructive Shock

Background: The occurrence of a high-risk pulmonary embolism (PE) within 48 hours of a complicated pericardiocentesis to remove a haemorrhagic pericardial effusion, is an uncommon clinical challenge. Case summary: The authors report the case of a 75-year-old woman who presented with signs of imminent cardiac tamponade due to recurring idiopathic pericardial effusion. The patient underwent pericardiocentesis that was complicated by the loss of 1.5 litres of blood. Within 48 hours, the patient had collapsed with clear signs of obstructive shock. This was a life-threating situation so alteplase was administered after cardiac tamponade and hypertensive pneumothorax had been excluded. CT chest angiography later confirmed bilateral PE. The patient achieved haemodynamic stability less than an hour after receiving the alteplase. However, due to the high risk of bleeding, the medical team suspended the thrombolysis protocol and switched to unfractionated heparin within the hour. The cause of the PE was not identified despite extensive study, but after 1 year of follow-up the patient remained asymptomatic. Discussion: Despite the presence of a contraindication, the use of thrombolytic therapy in obstructive shock after exclusion of hypertensive pneumothorax can be life-saving, and low-dose thrombolytic therapy may be a valid option in such cases.

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