Early thrombolysis in an elderly patient: case report

Background Pulmonary thromboembolism (TEP) is related to the migration of thrombotic material from the systemic venous circulation to pulmonary vascular tree, with obstruction of the pulmonary arterial circulation. The mortality rate is 30% in non-identifiable forms, and 2-8% in those treated earlier. The early use of thrombolytics determines the success of the lysis. Thrombolysis is considered a proven treatment in the management of acute, massive forms of TEP that accompany a hemodynamic instability, but differences arise over time, the doses and which thrombolytic use, to minimize the adverse events in compromised patients. Adverse events are: major bleeding, strokes, severe hypotension, allergies, re-thrombosis and reperfusion syndrome. Contraindications are: absolute (internal bleeding in progress, recent spontaneous intracranial hemorrhage) and relative (interventions Chir. <10 days, stroke <2m., Gastric bleeding <10 days, Major trauma <15 days, Recent CPR, PTL <100,000, poorly controlled severe hypertension, pregnancy).