RT Journal Article
SR Electronic
T1 Thrombolytic Therapy in a Patient With Suspected Pulmonary Embolism Despite a Negative Computed Tomography Pulmonary Angiogram
JF Respiratory Care
FD American Association for Respiratory Care
SP 336
OP 338
DO 10.4187/respcare.00738
VO 56
IS 3
A1 Urvashi Vaid
A1 Michael Baram
A1 Paul E Marik
YR 2011
UL http://rc.rcjournal.com/content/56/3/336.abstract
AB We report a case of a 62-year-old male who presented to our intensive care unit with hypoxemia 6 hours after retinal surgery. He had a negative computed tomography (CT) pulmonary angiogram, but an emergency echocardiogram revealed the McConnell sign. He was thrombolysed and had rapid improvement in oxygenation and hemodynamics. Thrombolysis in hemodynamically unstable pulmonary embolism is not controversial, but most algorithms require confirmation of the diagnosis. Our patient had a negative CT pulmonary angiogram but was thrombolysed based on the clinical picture. Autopsy confirmed the diagnosis of multiple pulmonary emboli and unexpectedly discovered a patent foramen ovale that explained paradoxical embolism to the brain.