[Massive pulmonary thromboembolism treated successfully with streptokinase. Report of one case].
Massive pulmonary thromboembolism has a high mortality. Early thrombolysis is the treatment of choice. We report a 79-year-old man admitted in shock. A chest angio-CAT scan showed a massive pulmonary thromboembolism. A transthoracic echocardiography showed a right cardiac dysfunction. Although the patient was in hemodynamic instability, he was subjected to thrombolysis with streptokinase, assisted with noradrenaline support and invasive mechanical ventilation. Parenteral anticoagulation was started thereafter. A second echocardiography, performed 72 hours later showed an improvement in right ventricular function. The patient had a nosocomial pneumonia that was treated. Noradrenalin and mechanical ventilation were discontinued nine and 15 days after thrombolysis. A new angio-CAT scan, 23 days after the procedure, was normal. The patient was discharged in good conditions 27 days after admission.
Facultad de Medicina Sede Oriente, Universidad de Chile. jileal@gmail.com
José Luis
JL
Leal
Pilar
P
Lora
Giovanni
G
Enciso
Enrique
E
Reynolds
D000368:Aged; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy*; D013300:Streptokinase / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
D005343:Fibrinolytic Agents; D013300:Streptokinase