Tromboembolismo pulmonar masivo con respuesta exitosa a trombolisisfarmacológica: Caso clínico

• JOSÉ LUIS LEAL ^[1] ; PILAR LORA ^[1] ; GIOVANNI ENCISO ^[1] ; ENRIQUE REYNOLDS ^[1]
  1. [1] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 138, Nº. 7, 2010, págs. 856-861
• Idioma: español
• Títulos paralelos:
  • Massive pulmonary thromboembolism treated successfully with streptokinase: Report of one case
• Enlaces
  • Texto completo
• Resumen

  • 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.