Massive Pulmonary Thromboembolism Treated with Heparin and Extracorporeal Membrane Oxygenation During Cardiogenic Shock

ABSTRACT

A 48-year-old woman visited the emergency department, complaining of syncope and chest pain. Her initial vital signs were unstable and her blood pressure was manually uncheckable. Despite inotropics and fluid replacement, the patient collapsed and required cardiopulmonary resuscitation (CPR). During the first CPR, emergent echocardiography revealed severe right ventricular dysfunction. Under clinical suspicion of massive pulmonary thromboembolism (PTE), heparin was administered and extracorporeal membrane oxygenation (ECMO) implanted by the femoral vessels during resuscitation. ECMO was removed on the third hospital day and the patient was discharged under a tolerable state. We report the survival of a patient from massive PTE by treatment with heparin therapy and ECMO.