[Tenecteplase for massive pulmonary embolism in a 92-year-old man]

Area of Science:

• Cardiology
• Geriatrics
• Emergency Medicine

Background:

• Massive pulmonary embolism (PE) poses significant risks, especially in the elderly, due to increased susceptibility to hemorrhagic complications.
• The decision-making process for thrombolytic therapy in older adults with massive PE is complex, balancing efficacy against bleeding risks.

Observation:

• A 92-year-old male presented with recurrent syncopal episodes, indicative of a critical cardiovascular event.
• Echocardiography was instrumental in diagnosing massive pulmonary embolism, highlighting its diagnostic utility in critical care settings.

Findings:

• Thrombolytic therapy with tenecteplase was administered and proved successful in this elderly patient.
• The treatment led to rapid thrombus resolution and achieved hemodynamic stability.
• No major hemorrhagic complications were observed post-treatment, suggesting a favorable safety profile in this specific case.

Implications:

• This case demonstrates the potential safety and efficacy of tenecteplase for massive PE in very elderly patients.
• Echocardiography is a valuable tool for rapid diagnosis of massive PE in emergency settings.
• Careful patient selection and monitoring may allow for successful thrombolytic therapy in high-risk elderly populations.