[Recurrent pulmonary embolism with prolonged right heart failure and hypoxia after cerebral bleeding; report of a case].
A 56-year-old woman with right hemiplegia for recent cerebral bleeding suddenly complained of dyspnea and chest pain with hypoxia during rehabilitation. Eight days after this first attack, she suffered prolonged right heart failure and hypoxia due to recurrent pulmonary embolism. Arterial blood gas analysis of room air showed 34.5 mmHg of PaO2 and 29.2 mmHg of PaCO2. Echocardiography showed enlargement of the right atrium and ventricle with pulmonary hypertension. Enhanced chest computed tomography revealed pulmonary emboli from the main pulmonary artery to the periphery. Despite intensive treatment, heart failure and hypoxia did not improve. We conducted pulmonary embolectomy under cardiopulmonary bypass requiring percutaneous cardiopulmonary bypass support for 2 days due to right heart failure. She is currently doing well in the 9 months following surgery.
Division of Thoracic and Cardiovascular Surgery, Southern Tohoku General Hospital, Kooriyama, Japan.
T
T
Tatebayashi
M
M
Kanno
M
M
Tezuka
S
S
Nitta
D002543:Cerebral Hemorrhage / Q000150:complications*; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D000860:Hypoxia / Q000150:complications*; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology / Q000601:surgery*; D012008:Recurrence