J Korean Soc Emerg Med.  2013 Oct;24(5):622-626.

Massive Pulmonary Thromboembolism Treated with Heparin and Extracorporeal Membrane Oxygenation During Cardiogenic Shock

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, St.Vincent's Hospital, The Catholic University of Korea, Suwon, Republic of Korea. anthleemd@naver.com

Abstract

A 48-year-old woman visited the emergency department, complaining of syncope and chest pain. Her initial vital signs were unstable and her blood pressure was manually uncheckable. Despite inotropics and fluid replacement, the patient collapsed and required cardiopulmonary resuscitation (CPR). During the first CPR, emergent echocardiography revealed severe right ventricular dysfunction. Under clinical suspicion of massive pulmonary thromboembolism (PTE), heparin was administered and extracorporeal membrane oxygenation (ECMO) implanted by the femoral vessels during resuscitation. ECMO was removed on the third hospital day and the patient was discharged under a tolerable state. We report the survival of a patient from massive PTE by treatment with heparin therapy and ECMO.

Keyword

Pulmonary thromboembolism; Extracorporeal membrane oxygenation

MeSH Terms

Blood Pressure
Cardiopulmonary Resuscitation
Chest Pain
Echocardiography
Emergencies
Extracorporeal Membrane Oxygenation*
Female
Heparin*
Humans
Middle Aged
Pulmonary Embolism*
Resuscitation
Shock, Cardiogenic*
Syncope
Ventricular Dysfunction, Right
Vital Signs
Heparin
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