[Massive pulmonary thromboembolism treated successfully with streptokinase. Report of one case].

Abstract

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.

• Authors: José Luis Leal, Pilar Lora, Giovanni Enciso, Enrique Reynolds
• Journal: Revista medica de Chile (Rev Med Chil) Vol. 138 Issue 7 Pg. 856-61 (Jul 2010) ISSN: 0034-9887 [Print] Chile
• Vernacular Title: Tromboembolismo pulmonar masivo con respuesta exitosa a trombolisis farmacológica. Caso clínico.
• PMID: 21043082 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Fibrinolytic Agents
• Streptokinase

Topics

• Aged
• Fibrinolytic Agents (therapeutic use)
• Humans
• Male
• Pulmonary Embolism (diagnosis, drug therapy)
• Streptokinase (therapeutic use)
• Tomography, X-Ray Computed