Guella Elhosseyn, Mitchell Louis James, Sobolewska Jolanta, Khan Kamal
Department of Internal Medicine, Pennine Acute Hospitals NHS Trust, Bury, UK.
Cardiology Department, The Royal Oldham Hospital, Oldham, UK.
BMJ Case Rep. 2016 Jun 21;2016:bcr2016215136. doi: 10.1136/bcr-2016-215136.
We present the case of a middle-aged man who was admitted with progressive shortness of breath and haemodynamic instability. He was diagnosed as having unprovoked bilateral central pulmonary emboli. Thrombolysis with alteplase was provided. Subsequently, an echocardiogram was performed which showed a thrombus straddling the interatrial septum. This was managed conservatively with enoxaparin anticoagulation. A repeat echocardiogram 2 days later showed complete resolution of the thrombus without clinical systemic arterial thromboembolic sequelae such as stroke, myocardial ischaemia or acute limb ischaemia.
我们报告一例中年男性病例，该患者因进行性气短和血流动力学不稳定入院。他被诊断为特发性双侧中央型肺栓塞。给予阿替普酶溶栓治疗。随后进行了超声心动图检查，结果显示有一个血栓横跨房间隔。对此采用依诺肝素抗凝进行保守治疗。两天后复查超声心动图显示血栓完全溶解，且未出现如中风、心肌缺血或急性肢体缺血等临床系统性动脉血栓栓塞后遗症。
