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High-Risk Pulmonary Embolism During Labor: JACC Patient Care Pathways
Hooman Poor1, Gregory Serrao2, Julia Grapsa3
1Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
JACC. Case Reports
|January 27, 2023
Summary
This case study highlights a peripartum woman with acute pulmonary embolism, emphasizing prompt diagnosis and multidisciplinary management. It also covers complications like heparin-induced thrombocytopenia and COVID-19.
Area of Science:
- Cardiology
- Pulmonology
- Obstetrics
Background:
- Acute pulmonary embolism (PE) is a life-threatening condition.
- Peripartum women face unique risks for thromboembolic events.
- Early recognition and intervention are critical for favorable outcomes.
Purpose of the Study:
- To present a complex clinical case of acute pulmonary embolism in a peripartum patient.
- To underscore the importance of timely diagnosis and multidisciplinary management of PE.
- To discuss the approach to managing complications such as heparin-induced thrombocytopenia.
Main Methods:
- Case report of a 37-year-old woman in labor presenting with acute dyspnea and hypoxemia.
- Diagnostic workup included transthoracic echocardiography.
- Treatment involved percutaneous thrombectomy for bilateral pulmonary embolism.
Main Results:
- The patient experienced severe right ventricular dilation and dysfunction, indicative of acute PE.
- Successful percutaneous thrombectomy was performed.
- Complications included a recurrent saddle PE, heparin-induced thrombocytopenia, and concurrent COVID-19 infection.
Conclusions:
- Prompt diagnosis of acute pulmonary embolism in peripartum patients is crucial.
- A multidisciplinary approach is essential for managing complex PE cases.
- Effective strategies for managing complications like heparin-induced thrombocytopenia are vital for patient recovery.
Keywords:
CT, computed tomographyCTA, computed tomography angiogramCTPA, computed tomography pulmonary angiographyECMO, extracorporeal membrane oxygenationHIT, heparin-induced thrombocytopeniaLV, left ventriclePE, pulmonary embolismPVR, pulmonary vascular resistanceRV, right ventricleSBP, systolic blood pressureTTE, transthoracic echocardiogrammultimodality imagingpregnancypulmonary embolismMore Related Videos
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