Levosimendan has been used successfully in the treatment of ischaemic cardiac failure and myocardial stunning. There is growing evidence from both human and animal experiments that levosimendan has particularly favourable effects on the right ventricle. We describe a case of life-threatening pulmonary embolus supported by the use of levosimendan.
KonstantinidesS., GeibelA., HeuselG., HeinrichF., KasperW; Management Strategies and Prognosis of Pulmonary Embolism-3 Trial Investigators. Heparin plus alteplase compared with heparin alone in patients with submassive pulmonary embolism.N Engl J Med2002; 347: 1143–1150.
2.
GoldhaberS.Z., VisaniL., De RosaM.Acute pulmonary embolism: clinical outcomes in the international cooperative pulmonary embolism registry (ICOPER).Lancet1999; 353: 1386–1389.
3.
McIntyreK., SasaharaA.Determinants of right ventricular function and haemodynamics after pulmonary embolism.Chest1974; 65: 534–543.
4.
British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group.British Thoracic Society guidelines for the management of suspected acute pulmonary embolism.Thorax2003; 58: 470–484.
5.
OldnerA., KonradD., WeitzbergE., RudehillA., RossiP., WanecekM.Effects of levosimendan, a novel inotropic calcium-sensitizing drug, in experimental septic shock.Crit Care Med2001; 29: 2185–2193.
6.
MorelliA., De CastroS., TeboulJ.L., SingerM., RoccoM., ContiG.Effects of levosimendan on systemic and regional hemodynamics in septic myocardial depression.Intensive Care Med2005; 31: 638–644.
7.
MissantC., RexS., SegersP., WoutersP.F.Levosimendan improves right ventriculovascular coupling in a porcine model of right ventricular dysfunction.Crit Care Med2007; 35: 707–715.
8.
MorelliA., TeboulJ.L., MaggioreS.M., Vieillard-BaronA., RoccoM., ContiG.Effects of levosimendan on right ventricular overload in patients with acute respiratory distress syndrome: a pilot study.Crit Care Med2006; 34: 2287–2293.
9.
KerbaulF., RondeletB., DemesterJ.P., FeslerP., HuezS., NaeijeR.Effects of levosimendan versus dobutamine on pressure load-induced right ventricular failure.Crit Care Med2006; 34: 2814–2819.
10.
MebazaaA., NieminenM.S., PackerM., Cohen-SolalA., KleberF.X., PocockS.J.Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE Randomized Trial.JAMA2007; 297: 1883–1891.
