Fasullo Sergio, Morabito Nicola, Cannizzaro Sergio, Cosenza Gioacchino, Pinto Vito, Ganci Filippo, Scalzo Sebastiano, Davi Stefania, Maringhini Giorgio
Department of Cardiology, Coronary Care Unit, G.F. Ingrassia Hospital Palermo, Italy.
Emergency Room G.F. Ingrassia Hospital Palermo, Italy.
J Cardiovasc Echogr. 2018 Jan-Mar;28(1):54-58. doi: 10.4103/jcecho.jcecho_35_17.
Free-floating thrombus in the right ventricle, associated with a massive acute pulmonary embolism (PE), is a rare phenomenon. PE is an important clinical entity with considerable mortality despite advances in diagnosis and treatment. The prognosis of PE depends on right ventricular dysfunction, myocardial injury markers, and early treatment. In this report, we present the case of a 71-year-old woman with a history of breast cancer admitted to intensive care unit for PE complicated by syncope. Although our case may seem complex because it is not represented in the guidelines, the result was satisfactory and showed how treatment with new anticoagulants (in this case apixaban) after massive thrombolysis of PE could be considered and included in the new guidelines.
右心室内的游离血栓，与大面积急性肺栓塞（PE）相关，是一种罕见现象。尽管在诊断和治疗方面取得了进展，但PE仍是一种具有相当高死亡率的重要临床病症。PE的预后取决于右心室功能障碍、心肌损伤标志物以及早期治疗。在本报告中，我们介绍了一名71岁乳腺癌病史的女性患者，因PE并发晕厥入住重症监护病房。尽管我们的病例可能看似复杂，因为指南中未提及，但结果令人满意，并展示了在PE进行大规模溶栓后使用新型抗凝剂（本例为阿哌沙班）进行治疗如何能够被考虑并纳入新指南。
