title: Importance of clinical and echocardiographic hemodynamic assessment in chronic pulmonary embolism.
abstract: We describe a 42-year-old man presenting to the emergency department with cardiogenic shock. He had a prior history of acute pulmonary embolism (PE), and had been on anticoagulation for 2 years. Although computed tomographic pulmonary angiography performed at the emergency department showed no change in the extent of PE and did not support a role of surgical treatment, pulmonary embolectomy was recommended by attending physician based on clinical and echocardiographic hemodynamic findings like unstable vital sign and markedly enlarged right ventricle with severely depressed systolic function. Surgery confirmed the presence of fresh thrombi. After surgery, hemodynamic status was progressively improved, but the patient died due to pneumonia and pulmonary hemorrhage.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Won-Seok
authors.initials: WS
authors.lastname: Choe
authors.forename: Do-Yoon
authors.initials: DY
authors.lastname: Kang
authors.forename: Jung-Han
authors.initials: JH
authors.lastname: Yoon
authors.forename: Min-Ho
authors.initials: MH
authors.lastname: Lee
authors.forename: Myung-Jin
authors.initials: MJ
authors.lastname: Cha
authors.forename: Hyung-Kwan
authors.initials: HK
authors.lastname: Kim
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Goo-Yeong
authors.initials: GY
authors.lastname: Cho
authors.forename: Dae-Won
authors.initials: DW
authors.lastname: Sohn