RT Book, Section
A1 K. Sista, Akhilesh
A1 Kearon, Clive
A2 Baliga, R. R.
A2 Lilly, Scott M.
A2 Abraham, William T.
SR Print(0)
ID 1160207534
T1 Catheter-Directed Therapy for Severe Pulmonary Embolism
T2 Color Atlas and Synopsis of Interventional Cardiology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071749350
LK accesscardiology.mhmedical.com/content.aspx?aid=1160207534
RD 2024/04/24
AB A  63-year-old  man  arrives  in  the  emergency  department  with  acute  shortness  of  breath.  His  past  medical  history  is  remarkable  for  well-controlled  hypertension.  On  admission,  his  heart  rate  is  113  bpm,  oxygen  saturation  is  91%,  and  respiratory  rate  is  35  breaths/min.  His  blood  pressure  is  145/65  mm  Hg.  He  underwent  knee  replacement  surgery  15  days  earlier.  His  physical  examination  is  unremarkable,  as  are  an  electrocardiogram  and  chest  radiograph.  Computed  tomography  pulmonary  angiography  of  the  chest  demonstrates  large  thrombi  in  the  right  and  left  main  pulmonary  arteries,  extending  into  the  lobar  branches.  His  right-to-left  ventricular  ratio  is  markedly  increased  at  1.2,  and  troponin  is  elevated.  Echocardiography  performed  at  the  bedside  reveals  moderate  right  ventricular  hypokinesis  and  dilation.  He  is  started  on  intravenous  heparin  and  admitted  to  the  intensive  care  unit.