tailieunhanh - Báo cáo hóa học: " Unexpected bilateral massive pulmonary embolism Zaffer Qasim"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí hóa hoc quốc tế đề tài : Unexpected bilateral massive pulmonary embolism Zaffer Qasim | Qasim International Journal of Emergency Medicine 2011 4 70 http content 4 1 70 o International Journal of Emergency Medicine a SprlngerOpen Journal CASE REPORT Open Access Unexpected bilateral massive pulmonary embolism Zaffer Qasim Case report A 59-year-old woman with a past history of rheumatoid arthritis arrived in our Emergency Department via ambulance. Her husband stated she had suddenly appeared very strange whilst preparing to go out for the afternoon but could not identify specific symptoms. Physical examination showed her to have sinus tachycardia and tachypnea but little else of note. Her oxygen saturations however rapidly dropped when she was taken off high-flow oxygen. Her D-dimer assay was markedly elevated and urgent computed tomographic pulmonary angiography CTPA was performed Figures 1 and 2 . This showed large emboli black arrows in both the left Figure 1 and right Figure 2 pulmonary arteries white arrows with a saddle embolus noted on the right. Following the CTPA she developed signs and Figure 2 CTPA image showing similar saddle embolus white arrows in right pulmonary artery of the same patient. Figure 1 CTPA image of left pulmonary artery showing saddle embolus black arrows . Correspondence zaffer_qasim@ Emergency Department Manchester RoyalInfirmary Oxford Road Manchester M13 9WL UK symptoms of obstructive shock requiring urgent thrombolysis using tenectaplase and admission to the intensive care unit. Her hospital stay was complicated by a lower respiratory tract infection but she was discharged 17 days after her admission. Rheumatoid arthritis may be complicated by venous thrombotic disease with up to 33 of cases being associated with antiphospholipid syndrome 1 . Antiphospholipid antibodies may have precipitated the events in our patient. When the patient s condition deteriorated we resorted to thrombolytic therapy. There are clear indications for the administration of thromobolytic agents. The most recent .

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