RESUMO
This is a case of a 68-year-old man with Parkinson's disease who was admitted in the psychiatry floor for new-onset aggressive behaviour and hallucinations. On the third day of hospitalisation, he suddenly developed dyspnoea followed by an ECG showing atrial fibrillation with rapid ventricular response. A few seconds later, he went into cardiac arrest; he was resuscitated after multiple rounds of Advanced Cardiovascular Life Support. A transthoracic echo showed hypokinetic and enlarged right ventricle. A CT Chest showed a saddle embolus. Patient was provided with systemic thrombolysis, which led to an improvement in his haemodynamic status. Interestingly, his psychotic symptoms also improved. In this paper, we present and review how pulmonary embolism can be associated with acute psychosis.
Assuntos
Alucinações/etiologia , Parada Cardíaca/etiologia , Doença de Parkinson/psicologia , Transtornos Psicóticos/etiologia , Embolia Pulmonar/psicologia , Idoso , Humanos , Masculino , Doença de Parkinson/complicações , Embolia Pulmonar/complicaçõesAssuntos
Neoplasias Ósseas , Neoplasias da Mama , Mediastinite/diagnóstico , Artéria Pulmonar/patologia , Veias Pulmonares/patologia , Esclerose/diagnóstico , Esterno , Idoso , Constrição Patológica , Diagnóstico Diferencial , Dispneia/etiologia , Feminino , Humanos , Mediastinite/diagnóstico por imagem , Metástase Neoplásica , Cuidados Paliativos , Artéria Pulmonar/diagnóstico por imagem , Veias Pulmonares/diagnóstico por imagem , Esclerose/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Lymphoepithelioma-likethymic carcinoma is a rare neoplasm that presents with compressive symptoms or as an incidental radiological finding of an anterior mediastinal mass. It is an aggressive carcinoma with a high rate of invasion, metastasis and recurrence. Its diagnosis usually carries a poor prognosis largely due to propensity for late diagnosis. To date, guidance for treatment remains limited. This is a case of lymphoepithelioma-like thymic carcinoma in a young male adult who presented initially with back pain. Despite prompt initiation of chemotherapy with cisplatin, doxorubicin and cyclophosphamide, he had a complicated hospital course leading to demise within 2 months of diagnosis.