Tromboembolismo pulmonar masivo con respuesta exitosa a trombolisisfarmacológica: Caso clínico

Massive pulmonary thromboembolism has a high mortality. Early thrombolysis is the treatment of choice. We report a 79-year-old man admitted in shock. A chest angio-CAT scan showed a massive pulmonary thromboembolism. A transthoracic echocardiography showed a right cardiac dysfunction. Although the patient was in hemodynamic instability, he was subjected to thrombolysis with streptokinase, assisted with noradrenaline support and invasive mechanical ventilation. Parenteral anticoagulation was started thereafter. A second echocardiography, performed 72 hours later showed an improvement in right ventricular function. The patient had a nosocomial pneumonia that was treated. Noradrenalin and mechanical ventilation were discontinued nine and 15 days after thrombolysis. A new angio-CAT scan, 23 days after the procedure, was normal. The patient was discharged in good conditions 27 days after admission.

Bibliographic Details

Main Authors:	LEAL,JOSÉ LUIS, LORA,PILAR, ENCISO,GIOVANNI, REYNOLDS,ENRIQUE
Format:	Digital revista
Language:	Spanish / Castilian
Published:	Sociedad Médica de Santiago 2010
Online Access:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000700011
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