Massive pulmonary embolism (PE) constitutes the most unexpected cause of death in necropsy. Consequently, prompt diagnosis and treatment is considered imperative. This article reports the case of a 37-year-old man who presented with cardiogenic shock due to PE as detected with bedside echocardiography in the emergency department. The authors wish to emphasize the usefulness of emergency bedside echo-Doppler for a prompt diagnosis and treatment of this life threatening condition.
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References
1.
Kauczor HU, Heussel CP, Thelen M.: Update on diagnostic strategies of pulmonary embolism. Eur Radiol9:262-275, 1999.
Galrinho A., Abreu A., Freitas A., et al: Importance of multiplane transesophageal echocardiography in the diagnosis of pulmonary embolism. Rev Port Cardiol18:45-51, 1999.
4.
Mathis G., Bitschnau R., Gehmacher O., et al: Chest ultrasound in diagnosis of pulmonary embolism in comparison to helical CT. Ultraschall Med20:54-59, 1999.
5.
Ribeiro A.: The role of echocardiography Doppler in pulmonary embolism. Echocardiography15:769-777, 1998.
6.
Casazza F., Bongarzoni A., Centonze F., et al: Prevalence and prognostic significance of right-sided cardiac mobile thrombi in acute massive pulmonary embolism. Am J Cardiol79:1433-1435, 1997.
7.
Augusseau-Richard MP, Pacouret G., Dessenne X., et al: Echocardiography in pulmonary embolism . Arch Mal Coeur Vaiss88 (suppl 11):1715-1722, 1995.
8.
Kasper W., Konstantinides S., Geibel A., et al: Prognostic significance of right ventricular afterload stress detected by echocardiography in patients with clinically suspected pulmonary embolism. Heart77:346-349, 1997.
9.
Lengyel M.: Should transesophageal echocardiography become a routine test in patients with suspected pulmonary thromboembolism. Echocardiography15:779-785, 1998.
10.
Cheriex EC, Sreeram N., Eussen YF, et al: Cross sectional Doppler echocardiography as the initial technique for the diagnosis of acute pulmonary embolism. Br Heart J72:52-57, 1994.
11.
Kasper W., Konstantinides S., Geibel A., et al: Management strategies and determinants of outcome in acute major pulmonary embolism: Results of a multicenter registry. J Am Coll Cardiol30:1165-1171, 1997.
12.
Arcasoy SM, Kreit JW: Thrombolytic therapy of pulmonary embolism. A comprehensive review of current evidence. Chest115:1695-1707, 1999 .
13.
Goldhaber SZ : Pulmonary embolism thrombolysis. Broadening the paradigm for its administration. Circulation96:716-718, 1997.
14.
Goldhaber SZ : Pulmonary embolism. N Engl J Med339:93-101, 1998.
15.
Ryan J., Lasorda D., Spero J., et al: Thrombolysis of right atrial thrombus with pulmonary embolism in anticardiolipin antibody syndrome. Am Heart J130:905-907, 1995.
16.
Greco F., Bisignani G., Serafini O., et al: Successful treatment of right heart thromboemboli with IV recombinant tissue-type plasminogen activator during continuous echocardiographic monitoring: A case series report. Chest116:78-82, 1999.
17.
Konstantinides S., Geibel A., Olschewski M., et al: Association between thrombolytic treatment and the prognosis of hemodynamically stable patients with major pulmonary embolism: Results of a multicenter registry. Circulation96:882-888, 1997.