Division of Cardiology, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Division of Respirology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada.
Can J Cardiol. 2019 Jul;35(7):940.e1-940.e3. doi: 10.1016/j.cjca.2019.03.007. Epub 2019 Mar 19.
We describe the case of a 55-year-old patient with a history of pulmonary embolism who presented in shock with ST-elevation on his electrocardiogram. He was triaged to the catheterization laboratory where he suffered a cardiac arrest. A pulmonary embolism was diagnosed angiographically, the thrombus was aspirated, and he received systemic thrombolysis. The combination of clot debulking and systemic thrombolysis acted synergistically to improve his right ventricular function by resolving his pulmonary hypertension. Although it is associated with a higher bleeding risk, the combination of clot aspiration with a thrombolytic agent in the treatment of massive pulmonary embolism in young patients might warrant further study.
我们描述了一位 55 岁的患者，该患者有肺栓塞病史，出现心电图 ST 段抬高的休克表现。他被分诊到导管室，在那里他发生了心脏骤停。血管造影诊断为肺栓塞，血栓被抽吸，他接受了全身溶栓治疗。血栓清除术和全身溶栓治疗的联合作用通过缓解肺动脉高压协同改善右心室功能。虽然这种联合治疗与更高的出血风险相关，但在年轻患者中使用血栓抽吸术联合溶栓药物治疗大面积肺栓塞可能需要进一步研究。
