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Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
09:22

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Published on: November 4, 2015

Massive pulmonary embolus without hypoxemia.

J Scott Baird1, Anne Greene, Charles L Schleien

  • 1Columbia University, College of Physicians and Surgeons, New York, USA.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|September 9, 2005
PubMed
Summary
This summary is machine-generated.

This case report highlights a massive pulmonary embolism in a teenager that presented without hypoxemia, potentially due to ibuprofen's cyclooxygenase inhibition improving ventilation-perfusion mismatch.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Pharmacology

Background:

  • Massive pulmonary embolism (PE) typically presents with hypoxemia.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can affect prostaglandin synthesis.

Observation:

  • A 16-year-old male with supraventricular tachycardia developed shortness of breath and chest pain post-electrophysiology study.
  • He received ibuprofen for 3 days prior to diagnosis of massive PE and left external iliac vein thrombus.
  • Despite massive PE, the patient exhibited hypocarbia without hypoxemia (Pao2 108 mm Hg).

Findings:

  • Massive pulmonary embolism diagnosed via V/Q scan and CT angiography.
  • Treatment included anticoagulation, thrombolysis, iliac vein stenting, and inferior vena cava filter placement.
  • Patient improved and was discharged on oral anticoagulation.

Implications:

  • Ibuprofen's potential cyclooxygenase inhibition may have mitigated hypoxemia in massive PE by improving ventilation-perfusion matching.
  • This case suggests a possible protective effect of NSAIDs in certain PE scenarios.
  • Further research is warranted to explore the relationship between NSAID use and PE presentation.