大面积肺栓塞伴右心血栓。
Submassive pulmonary embolism with a right heart thrombus.
机构信息
Critical Care Medicine, NYU Langone Health, New York, New York, USA
Critical Care Medicine, NYU Langone Health, New York, New York, USA.
出版信息
BMJ Case Rep. 2021 Jul 21;14(7):e242092. doi: 10.1136/bcr-2021-242092.
A 49-year-old woman presented to the hospital with shortness of breath 2 weeks after a left total hip replacement. She was found to have a submassive pulmonary embolism (PE), with her case complicated by the detection of a large mobile clot in transit extending through a patent foramen ovale between the right and left atria. The presence of this free-floating right heart thrombus (FFRHT) increases her risks of stroke and mortality, yet the optimal approach to her treatment was unclear. Ultimately, intravenous tissue plasminogen activator was administered with resolution of the clot. Treatment was complicated by haemodynamically insignificant bleeding at the site of recent surgery. Herein, we further discuss the implications and treatment options for patients with an FFRHT in the setting of an acute PE.
一位 49 岁女性在左侧全髋关节置换术后 2 周因呼吸急促到医院就诊。她被诊断为亚大块肺栓塞（PE），病情复杂，检测到一个大的移动栓子在卵圆孔未闭处从右心房延伸至左心房。这种游离的右心血栓（FFRHT）增加了她中风和死亡的风险，但她的治疗最佳方法尚不清楚。最终，给予了静脉组织型纤溶酶原激活剂，血栓得到了溶解。治疗因近期手术部位出现血流动力学无意义的出血而变得复杂。在此，我们进一步讨论了急性 PE 中存在 FFRHT 的患者的影响和治疗选择。
Zotero 插件