Diagnóstico y manejo de tromboembolismo pulmonar agudo: informe de caso

Abstract

Background: Pulmonary Thromboembolism (PTE) is an important cause of hospitalization, morbidity and mortality. At the present time it represents one of the most frequent cardiovascular diseases.Case report: A 73-year-old female patient with various comorbidities, who was admitted due to severe respiratory distress and hemodynamic instability, was diagnosed with pneumonia, pulmonary hypertension, and a Computed Axial Tomography revealed a tumor mass with alveolar hemorrhage.Evolution: During the hospital stay, the patient maintained high oxygen needs and hemodynamic instability despite support maneuvers. The alveolar hemorrhage that she presents determines the prophylactic thrombus treatment. The imaging study indicates a tumor mass associated with alveolar hemorrhage and a very high probability of developing deep vein thrombosis (DVT) and subsequent pulmonary thromboembolism (PTE). Reason for which FAST echo was performed, which evidenced deep vein thrombosis in the right common femoral vein, total occlusion of the superficial femoral artery with preserved flow in the deep femoral artery. Absent distal pulses with arterial flow in monophasic anterior tibial with high diastole IR: 0.6, and Ankle arm index 0.5, posterior echocardiogram with dilation of the right cavities, PSAP of 54 mmHg and McConnel's sign. Patient intervenes with a massive pulmonary thromboembolism that results in death.Conclusions: Pulmonary embolism is a pathology that occurs in 1 per 1000 cases. Individualizing each case can be decisive to safeguard the life of a patient.