[Acute intermediate-risk pulmonary embolism with right-sided free-floating intracardiac thrombus, systemic inflammatory reaction syndrome, multiple organ dysfunction syndrome, disseminated intravascular coagulation and acute ischaemia of a limb].
A case of a 64 year-old woman admitted to ICCU because of severe dyspnoea and oedema of left lower limb is presented. We diagnosed coincidence of acute pulmonary embolism with right-sided free-floating heart thrombi, systemic inflammatory reaction syndrome, multiple organ dysfunction syndrome, disseminated intravascular coagulation and acute ischaemia of the right lower limb. Due to atypical clinical presentation therapeutic strategies were discussed with ZATPOL registry coordinator. The patient was treated pharmacologically, underwent cardiosurgical evacuation of right-sided intracardiac thrombus and lower limb amputation. At follow up visit 6 months after discharge from hospital she was in good general condition with no complaints.
Klinika Kardiologii i Kardiochirurgii, 10. Wojskowy Szpital Kliniczny z Polikliniką, Bydgoszcz. pablo@mp.pl
Paweł
P
Grzelakowski
Tomasz
T
Lugowski
Marcin
M
Kurzyna
Maurycy
M
Missima
Michał
M
Maciejewski
Marek
M
Balcerzak
Robert
R
Romanek
Marek
M
Stelak
Andrzej
A
Lugowski
Aleksander
A
Goch
D003328:Coronary Thrombosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D004487:Edema / Q000150:complications; D004489:Edema, Cardiac / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000175:diagnosis; D007866:Leg / Q000098:blood supply; D055806:Microvessels / Q000503:physiopathology; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications / Q000175:diagnosis* / Q000628:therapy