title: Pulmonary embolism in deceivingly stable patients with high thrombus load-when is stable really safe?
abstract: The definitive treatment of hemodynamically stable patients with pulmonary embolism and echocardiographically proven moderate to severe right ventricular dysfunction is unclear. We discuss the cases of a 45-year-old woman and a 62-year-old man that fulfilled the above criteria, but had a high risk for adverse events. Although both patients were treated according to current guidelines, one underwent successful surgical embolectomy the same day and the other was resuscitated a few days later. Surgery is an alternative for carefully selected patients with mild right ventricular dysfunction, but a high risk for adverse events that would otherwise be treated the same way as low- to moderate-risk patients.
authors: Department of Internal Medicine V, University Hospital of Saarland, Homburg, Germany.
authors: Philipp M
authors: PM
authors: Lepper
authors: Department of Internal Medicine V, University Hospital of Saarland, Homburg, Germany.
authors: Heinrike
authors: H
authors: Wilkens
authors: Department of Internal Medicine III, University Hospital of Saarland, Homburg, Germany.
authors: Andreas
authors: A
authors: Link
authors: Department of Internal Medicine V, University Hospital of Saarland, Homburg, Germany.
authors: Robert
authors: R
authors: Bals
authors: Department of Thoracic and Cardiovascular Surgery, University Hospital of Saarland, Homburg, Germany.
authors: Hans-Joachim
authors: HJ
authors: Schäfers
mesh_terms: D004452:Echocardiography; D017128:Embolectomy / Q000009:adverse effects; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D018579:Patient Selection; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012307:Risk Factors; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy / Q000009:adverse effects; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D016278:Ventricular Function, Right