dos Santos Luís Ferreira, Andrade Cláudia, Rodrigues Bruno, Moreira Davide, Delgado Anne, Manso Pedro, Pipa António, Gama Pedro, Nunes Luís, Dionísio Odete, Ribeiro Nuno, Santos Oliveira
Serviço de Cardiologia, Centro Hospitalar Tondela Viseu, E.P.E., Viseu, Portugal.
Rev Port Cardiol. 2012 May;31(5):389-94. doi: 10.1016/j.repc.2011.11.007.
We describe the case of a 37-year-old pregnant woman who presented at 29 weeks of gestation with syncope and shortness of breath caused by pulmonary embolism. Due to persistent hypotension thrombolytic therapy with tenecteplase was administered and the clinical and hemodynamic response was excellent, with no maternal or fetal hemorrhagic complications. The clinical presentation of pulmonary embolism is sometimes camouflaged by the physiological changes that occur in pregnancy and diagnosis is often delayed by reluctance to expose the fetus to ionizing radiation. Systemic thrombolysis is considered a high-risk treatment in pregnancy and very few women have received it. However the complication rates of thrombolytic therapy are acceptable in the light of the underlying disease.
