Relapsing pulmonary embolism in a patient with a spinal cord-injury.

Spinal cord injures are associated with a high incidence of deep vein thrombosis (DVT), and, in consequence, associated also with a greater frequency of pulmonary emboli (PE), reported in the literature to occur in 70 to 100% of those cases . The extent of the pulmonar vascular obstruction is probably the most important determinant of the right ventricular dysfunction, which in turn leeds to worse prognosis and higher risk of death and reccurence . These patients are therefore good condidates for thrombolytic therapy. After clinical suspicion of PE, if there are unequivocally visible thrombi and signs of hight ventricular dysfunction at echocardiography, treatment, including thrombolysis, can be started . We report the case of a paraplegic patient with unusual echocardiographic findings in whon two different therapeutic approaches for PE could be evaluated.