A thirty-six-year-old female, who complained of dry cough symptoms, was treated based on a diagnosis of flu or asthma. However, the cough did not improve. She subsequently developed dyspnea and felled into both a hypoxic state and shock and she was transferred to this department. Electrocardiograms revealed incomplete right bundle block with ST depression on the right precordial leads and a blo...

Currently, no consensus exists for the appropriate treatment of echocardiographically diagnosed mobile right heart masses giving rise to a high suspicion of migrant thromboembolism in patients with pulmonary embolism. This may lead to unnecessary delay in the implementation of the most appropriate treatment for these patients. Several earlier studies have supported the beneficial role of thromb...

Recent advances in interventional cardiology, pharmacotherapeutics and modern surgical management in tertiary cardiac care centers have tremendously improved the present treatment of Pulmonary Embolism (PE). CT pulmonary angiography (CTPA), nuclear lung scan (V/Q scan), D-dimer test and modern echocardiography have revolutionized the diagnostic methodology and risk assessment criteria. Cardioge...

Background: Thrombolytic therapy in patients with sub-massive pulmonary embolism (SMPTE) needs further assessment. Objectives: The current study aimed to assess a potential benefit of thrombolytic and non-thrombolytic therapy in patients with SMPTE. Patients andMethods: One hundred-nineteen patients were enrolled with SMPTE from 2006 to 2010 in the tertiary care center of Rajaie medical and res...

The number of cancer patients admitted to intensive care units (ICUs) around the world has increased with recent improvements in cancer therapies. Cancer is now recognized as a chronic disease that is associated with possible acute decompensation caused by cardiovascular, respiratory or infectious disorders, which makes treating these patients challenging. Pulmonary thromboembolism is a common ...

In patients in whom there is clinical suspicion of pulmonary thromboembolic disease, because of the risk of inadequate treatment, definitive radiologic evaluation should be carried out. Of the diagnostic procedures available, conventional pulmonary angiography has the greatest sensitivity and specificity in the detection of pulmonary embolism or other pulmonary vascular disease. Pulmonary angio...

Use of thrombolytic therapy in pulmonary embolism is restricted in cases of massive embolism. It achieves faster lysis of the thrombus than the conventional heparin therapy thus reducing the morbidity and mortality associated with PE. The compartment syndrome is a well-documented, potentially lethal complication of thrombolytic therapy and known to occur in the limbs involved for vascular lines...

The dissolution of thrombi by enzymatic means has been investigated clinically and experimentally for a number of years. Experimentally it has been shown that the plasminogen activators, streptokinase and urokinase, accelerate resolution of pulmonary emboli in animals (Browse and James, 1964; Genton and Wolf, 1967a). Angiographic improvement has also been documented after thrombolytic therapy i...

BACKGROUND The relative effectiveness of vitamin K antagonists compared with novel oral anticoagulants in treating pulmonary embolism remains unclear. Recent trials comparing the efficacy of vitamin K antagonists with factor Xa inhibitors for the treatment of pulmonary emboli have been non-inferiority studies based primarily on risk reduction (such as bleeding events), rather than resolution of...

We describe the case of a 37-year-old pregnant woman who presented at 29 weeks of gestation with syncope and shortness of breath caused by pulmonary embolism. Due to persistent hypotension thrombolytic therapy with tenecteplase was administered and the clinical and hemodynamic response was excellent, with no maternal or fetal hemorrhagic complications. The clinical presentation of pulmonary emb...