High-Risk Pulmonary Embolism During Labor: JACC Patient Care Pathways

Area of Science:

• Cardiology
• Obstetrics
• Pulmonology

Background:

• Acute pulmonary embolism (PE) is a life-threatening condition.
• PE during pregnancy presents diagnostic and management challenges.
• Early recognition and intervention are crucial for maternal and fetal outcomes.

Observation:

• A 37-year-old woman in labor presented with acute dyspnea, hypoxemia, and tachycardia.
• Transthoracic echocardiography revealed severe right ventricular dilation and dysfunction, suggesting acute PE.
• The patient was diagnosed with bilateral pulmonary embolism.

Findings:

• The patient underwent percutaneous thrombectomy for bilateral pulmonary embolism.
• Complications included a recurrent saddle pulmonary embolus, heparin-induced thrombocytopenia, and COVID-19 infection.
• Successful management involved a multidisciplinary approach and long-term care strategies.

Implications:

• This case underscores the importance of timely PE diagnosis in peripartum patients.
• It demonstrates effective management of complex PE cases with multiple comorbidities.
• The study emphasizes the need for a comprehensive approach to acute pulmonary embolism, including long-term follow-up.