Critical Management of Haemodynamically Unstable Acute Pulmonary Embolism in COVID-19
Increased thrombotic events that occur in up to one-third of patients with COVID-19 are predominantly pulmonary emboli (PE), which are associated with higher severity and increased mortality. Acute PE should therefore be one of the main differential diagnoses among patients with hemodynamic instabil...
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| Format: | Article |
| Language: | English |
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Interna Publishing
2024-10-01
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| Series: | Acta Medica Indonesiana |
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| Online Access: | https://actamedindones.org/index.php/ijim/article/view/2414 |
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| author | Eka Adip Pradipta Vienna Rossimarina Indira Kemalasari Siska Suridanda Danny |
| author_facet | Eka Adip Pradipta Vienna Rossimarina Indira Kemalasari Siska Suridanda Danny |
| author_sort | Eka Adip Pradipta |
| collection | DOAJ |
| description | Increased thrombotic events that occur in up to one-third of patients with COVID-19 are predominantly pulmonary emboli (PE), which are associated with higher severity and increased mortality. Acute PE should therefore be one of the main differential diagnoses among patients with hemodynamic instability. Early treatment of such a condition with systemic thrombolysis remains the first line of treatment especially in patients with COVID-19, which hinders further invasive intervention. The aim of this report is to describe a typical case of hemodynamically unstable acute PE with COVID-19 management in our center to emphasize the role of early detection and prompt treatment of such a condition. A 66-year-old male suspected of having COVID-19 initially presented with shortness of breath and desaturation with normal physical examination, and turned out to be COVID-19 positive. In the isolation ward, he had a cardiac arrest, and bedside echocardiography showed a fresh thrombus had developed in the right atria with signs of acute right ventricular dysfunction. The diagnosis of acute PE with hemodynamic instability was established, and systemic thrombolysis was immediately initiated. The patient recovered well with improvement in his symptoms and was eventually safely discharged. Our case demonstrates how early recognition and prompt treatment of acute PE especially in COVID-19 patients with hemodynamic instability is a life-saving intervention. Identifying the subtle clues of acute PE in emergency situations remains the main challenge. |
| format | Article |
| id | doaj-art-93154f63ec7846aeb6b76d912026dd1f |
| institution | Kabale University |
| issn | 0125-9326 2338-2732 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | Acta Medica Indonesiana |
| spelling | doaj-art-93154f63ec7846aeb6b76d912026dd1f2025-01-27T04:12:06ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322024-10-01564702Critical Management of Haemodynamically Unstable Acute Pulmonary Embolism in COVID-19Eka Adip Pradipta0Vienna Rossimarina1Indira Kemalasari2Siska Suridanda Danny3Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia - Harapan Kita National Cardiovascular Center, Jakarta, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia - Harapan Kita National Cardiovascular Center, Jakarta, IndonesiaDepartment of Internal Medicine, Harapan Kita National Cardiovascular Center, Jakarta, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia - Harapan Kita National Cardiovascular Center, Jakarta, IndonesiaIncreased thrombotic events that occur in up to one-third of patients with COVID-19 are predominantly pulmonary emboli (PE), which are associated with higher severity and increased mortality. Acute PE should therefore be one of the main differential diagnoses among patients with hemodynamic instability. Early treatment of such a condition with systemic thrombolysis remains the first line of treatment especially in patients with COVID-19, which hinders further invasive intervention. The aim of this report is to describe a typical case of hemodynamically unstable acute PE with COVID-19 management in our center to emphasize the role of early detection and prompt treatment of such a condition. A 66-year-old male suspected of having COVID-19 initially presented with shortness of breath and desaturation with normal physical examination, and turned out to be COVID-19 positive. In the isolation ward, he had a cardiac arrest, and bedside echocardiography showed a fresh thrombus had developed in the right atria with signs of acute right ventricular dysfunction. The diagnosis of acute PE with hemodynamic instability was established, and systemic thrombolysis was immediately initiated. The patient recovered well with improvement in his symptoms and was eventually safely discharged. Our case demonstrates how early recognition and prompt treatment of acute PE especially in COVID-19 patients with hemodynamic instability is a life-saving intervention. Identifying the subtle clues of acute PE in emergency situations remains the main challenge.https://actamedindones.org/index.php/ijim/article/view/2414hemodynamic instabilitypulmonary embolismcoronavirus disease 2019 |
| spellingShingle | Eka Adip Pradipta Vienna Rossimarina Indira Kemalasari Siska Suridanda Danny Critical Management of Haemodynamically Unstable Acute Pulmonary Embolism in COVID-19 Acta Medica Indonesiana hemodynamic instability pulmonary embolism coronavirus disease 2019 |
| title | Critical Management of Haemodynamically Unstable Acute Pulmonary Embolism in COVID-19 |
| title_full | Critical Management of Haemodynamically Unstable Acute Pulmonary Embolism in COVID-19 |
| title_fullStr | Critical Management of Haemodynamically Unstable Acute Pulmonary Embolism in COVID-19 |
| title_full_unstemmed | Critical Management of Haemodynamically Unstable Acute Pulmonary Embolism in COVID-19 |
| title_short | Critical Management of Haemodynamically Unstable Acute Pulmonary Embolism in COVID-19 |
| title_sort | critical management of haemodynamically unstable acute pulmonary embolism in covid 19 |
| topic | hemodynamic instability pulmonary embolism coronavirus disease 2019 |
| url | https://actamedindones.org/index.php/ijim/article/view/2414 |
| work_keys_str_mv | AT ekaadippradipta criticalmanagementofhaemodynamicallyunstableacutepulmonaryembolismincovid19 AT viennarossimarina criticalmanagementofhaemodynamicallyunstableacutepulmonaryembolismincovid19 AT indirakemalasari criticalmanagementofhaemodynamicallyunstableacutepulmonaryembolismincovid19 AT siskasuridandadanny criticalmanagementofhaemodynamicallyunstableacutepulmonaryembolismincovid19 |