Bilateral Pulmonary Embolism With Right Heart Strain in a Patient With Immune Thrombocytopenia—A Case Report and Review of the Literature
| Autor: | Richard Aaron Brodsky, Channing Hui, Christopher J. Haines |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Adolescent Computed Tomography Angiography Heart Ventricles Population Strain (injury) 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine Humans Exertion Enoxaparin education Computed tomography angiography Purpura Thrombocytopenic Idiopathic education.field_of_study medicine.diagnostic_test business.industry Anticoagulants Immunoglobulins Intravenous 030208 emergency & critical care medicine Interventional radiology General Medicine Thorax medicine.disease Immune thrombocytopenia Surgery Pulmonary embolism Purpura Dyspnea Treatment Outcome Echocardiography Pediatrics Perinatology and Child Health Emergency Medicine Female medicine.symptom Pulmonary Embolism business |
| Zdroj: | Pediatric Emergency Care. 36:e227-e228 |
| ISSN: | 0749-5161 |
| DOI: | 10.1097/pec.0000000000002075 |
| Popis: | Objectives Patients with immune thrombocytopenia are at risk of both bleeding complications and venous thromboembolism. There is no standard to treating life-threatening pulmonary embolism in this population. This case illustrates the difficulty of treating significant thromboembolism in pediatric patients who have reduced clotting capacity. Case This case focuses on a 16-year-old pediatric patient with a history of immune thrombocytopenia presenting with mild chest discomfort and dyspnea on exertion. The d-dimer was mildly elevated, and the subsequent computed tomography angiogram revealed bilateral pulmonary embolisms with right ventricular strain. Conclusions The patient underwent thromboembolectomy by interventional radiology with subsequent administration of intravenous immunoglobulin, high-dose steroids, and enoxaparin therapy. There is no standard of care for patients with life-threatening pulmonary embolism in this population. Several authors suggest medical therapy options, but do not include patients with potential hemodynamic instability. |
| Databáze: | OpenAIRE |
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