Biggs Megan D, Bell Jonathan, Park Christopher
Internal Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, USA.
Cureus. 2022 Jun 22;14(6):e26211. doi: 10.7759/cureus.26211. eCollection 2022 Jun.
A pulmonary embolism (PE) that is located in the main pulmonary artery is known as a saddle pulmonary embolism. Individuals at high risk who become unstable often require surgical intervention or more aggressive management with thrombolytic therapy. COVID-19 is a known risk factor for a hypercoagulable state and therefore increases the risk of PE and its associated complications. Individuals hospitalized with the COVID-19 virus and who have evidence of right ventricular dysfunction with PE are found to have a significantly higher risk of mortality. We present a case of an individual with several high-risk factors for PE as well as COVID-19 infection and evidence of cardiac strain, making the decision for treatment less clear. He was, however, treated successfully with heparin and enoxaparin alone. Furthermore, our case hadresolving symptoms of COVID-19, highlighting the importance of high clinical suspicion for PE in those diagnosed with COVID-19.
位于主肺动脉的肺栓塞（PE）被称为马鞍状肺栓塞。高危且病情不稳定的个体通常需要手术干预或采用更积极的溶栓治疗。2019冠状病毒病（COVID - 19）是已知的高凝状态风险因素，因此会增加肺栓塞及其相关并发症的风险。因COVID - 19病毒住院且有肺栓塞合并右心室功能障碍证据的个体，其死亡风险显著更高。我们报告一例有多个肺栓塞高危因素以及COVID - 19感染且有心脏劳损证据的病例，这使得治疗决策不太明确。然而，他仅用肝素和依诺肝素就成功治愈。此外，我们的病例中COVID - 19症状得到缓解，这凸显了对COVID - 19确诊患者高度怀疑肺栓塞的重要性。
