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Pulmonary embolism: improvement in hemodynamic function with amrinone therapy.

T H Spence1, W D Newton

  • 1Department of Pulmonary Medicine, USAF Medical Center Keesler, Miss.

Southern Medical Journal
|October 1, 1989
PubMed
Summary

A patient with pulmonary embolism after vascular surgery improved with amrinone therapy. This treatment addressed persistent pulmonary hypertension and low cardiac output when other options were contraindicated.

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Area of Science:

  • Cardiology
  • Vascular Surgery
  • Pulmonary Medicine

Background:

  • Lower extremity vascular surgery carries risks, including pulmonary embolism (PE).
  • Pulmonary embolism can lead to severe complications such as dyspnea, hypotension, hypoxemia, and congestive heart failure (CHF).

Observation:

  • A 57-year-old male developed PE post-vascular surgery, presenting with dyspnea, hypotension, hypoxemia, and CHF.
  • Thrombolytic therapy was contraindicated due to the recent surgery.
  • Inferior vena cava plication was performed, but pulmonary artery hypertension persisted.

Findings:

  • Amrinone therapy was initiated due to persistent pulmonary artery hypertension and declining cardiac indices.
  • Amrinone resulted in significant hemodynamic improvement in the patient.

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Implications:

  • Amrinone can be a viable therapeutic option for managing hemodynamic compromise in PE patients with contraindications to thrombolysis.
  • This case highlights the importance of considering alternative treatments for severe pulmonary hypertension post-PE.
  • Effective management of PE complications is crucial in post-vascular surgery patients.