Massive Pulmonary Embolism with Thrombus-in-Transit Entrapped by a Patent Foramen Ovale / 대한내과학회지
Korean Journal of Medicine
;
: 61-64, 2018.
Article
in Korean
| WPRIM
| ID: wpr-741110
ABSTRACT
“Thrombus-in-transit” in pulmonary embolism is associated with high mortality and refers to a free-floating clot in the right atrium or right ventricle, indicating that deep vein thrombosis is present en route to the pulmonary artery. Thrombus entrapped in a patent foramen ovale (PFO) is a rare condition and is associated with paradoxical systemic embolism. Here, we report a case of acute pulmonary embolism with thrombus-in-transit through a PFO in a 68-year-old woman with a diagnosis of metastatic pancreatic cancer undergoing palliative chemotherapy. She presented with syncope after acute onset of exertional dyspnea and was diagnosed with cardiogenic shock due to massive pulmonary embolism with thrombus-in-transit on admission to the emergency room. We treated her with systemic thrombolysis and anticoagulation therapy instead of surgical thrombectomy. We show that hemodynamically unstable pulmonary embolism with thrombus-in-transit entrapped by a PFO may be successfully treated with systemic thrombolysis without paradoxical embolism.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pancreatic Neoplasms
/
Pulmonary Artery
/
Pulmonary Embolism
/
Shock, Cardiogenic
/
Syncope
/
Thrombosis
/
Thrombolytic Therapy
/
Mortality
/
Thrombectomy
/
Embolism, Paradoxical
Type of study:
Diagnostic study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
Language:
Korean
Journal:
Korean Journal of Medicine
Year:
2018
Type:
Article
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