| Autor: |
Ley L; Department of Radiology, Baden Cantonal Hospital, 5404 Baden, Switzerland.; Campus Kerckhoff, Justus-Liebig-University Giessen, 61231 Bad Nauheim, Germany., Messmer F; Department of Radiology, Baden Cantonal Hospital, 5404 Baden, Switzerland., Vaisnora L; Department of Cardiology, Baden Cantonal Hospital, 5404 Baden, Switzerland., Ghofrani HA; Universities of Giessen and Marburg Lung Center (UGMLC), 35392 Giessen, Germany., Bandorski D; Faculty of Medicine, Semmelweis University Campus Hamburg, 20099 Hamburg, Germany., Kostrzewa M; Department of Radiology, Baden Cantonal Hospital, 5404 Baden, Switzerland. |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of clinical medicine [J Clin Med] 2024 Apr 26; Vol. 13 (9). Date of Electronic Publication: 2024 Apr 26. |
| DOI: |
10.3390/jcm13092548 |
| Abstrakt: |
Background: Pulmonary embolism (PE) is a common disease with an annual incidence of about 1/1000 persons. About every sixth patient dies within the first 30 days after diagnosis. The electrocardiogram (ECG) is one of the first diagnostic tests performed, and is able to confirm the suspicion of PE with typical electrocardiographic signs. Some ECG signs and their regression are also prognostically relevant. Endovascular mechanical thrombectomy is one option for PE treatment, and aims to relieve right heart strain immediately. The first studies on endovascular mechanical thrombectomy using a dedicated device (FlowTriever System, Inari Medical, Irvine, CA, USA) yielded promising results. Methods: In the following, we report the case of a 66-year-old male patient who presented with New York Heart Association III dyspnea in our emergency department. Among typical clinical and laboratory results, he displayed very impressive electrocardiographic and radiological findings at the time of PE diagnosis. Results: After endovascular mechanical thrombectomy, the patient's complaints and pulmonary hemodynamics improved remarkably. In contrast, the ECG worsened paradoxically 18 h after intervention. Nevertheless, control echocardiography 4 days after the intervention no longer showed any signs of right heart strain, and dyspnea had disappeared completely. At a 4-month follow-up visit, the patient presented as completely symptom-free with a high quality of life. His ECG and echocardiography were normal and excluded recurrent right heart strain. Conclusions: Overall, the patient benefitted remarkably from endovascular mechanical thrombectomy, resulting in an almost complete resolution of electrocardiographic PE signs at the 4-month follow-up after exhibiting multiple typical electrocardiographic PE signs at time of diagnosis and initial electrocardiographic worsening 18 h post successful intervention. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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