- Case report
- Open Access
Unexpected bilateral massive pulmonary embolism
- Zaffer Qasim1Email author
https://doi.org/10.1186/1865-1380-4-70
© Qasim; licensee Springer. 2011
- Received: 22 June 2010
- Accepted: 18 November 2011
- Published: 18 November 2011
Keywords
- Pulmonary Embolism
- Thrombolytic Therapy
- Lower Respiratory Tract Infection
- Sinus Tachycardia
- Normotensive Patient
Case report
CTPA image of left pulmonary artery showing saddle embolus ( black arrows ).
CTPA image showing similar saddle embolus ( white arrows ) in right pulmonary artery of the same patient.
Rheumatoid arthritis may be complicated by venous thrombotic disease with up to 33% of cases being associated with antiphospholipid syndrome [1]. Antiphospholipid antibodies may have precipitated the events in our patient. When the patient's condition deteriorated, we resorted to thrombolytic therapy. There are clear indications for the administration of thromobolytic agents. The most recent recommendations from the American College of Chest Physicians [2] advise its use with evidence of hemodynamic compromise in the absence of contraindications to therapy, ideally via a peripheral vein, and utilizing a regimen with a short infusion time. There is less robust evidence to support the use of thrombolytics for high-risk, normotensive patients assessed to have a low bleeding risk, but outside these conditions, thrombolytics are not recommended.
Declarations
Authors’ Affiliations
References
- Gladd DA, Olech E: Antiphospholipid antibodies in rheumatoid arthritis: identifying the dominoes. Curr Rheumatol Rep 2009, 11(1):43–51. 10.1007/s11926-009-0007-3View ArticlePubMedGoogle Scholar
- Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ: Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guideline. Chest 8th edition. 2008, 133(6 Suppl):454S-545S. 10.1378/chest.08-0658View ArticlePubMedGoogle Scholar
Copyright
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.