Analgesia & Resuscitation : Current ResearchISSN: 2324-903X

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Case Report, Analg Resusc Curr Res Vol: 4 Issue: 1

Fulminant Pulmonary Embolism Successfully Treated with Thrombolysis

Franco Casazza*, Amedeo Bongarzoni, Giuseppe Guenzati, Guido Tassinario and Antonio Mafrici
Department of Cardiology, Ospedale San Carlo Borromeo, Milan, Italy
Corresponding author : Franco Casazza
Via Nikolajevka 12,20152, Milan, Italy
Received: January 07, 2015 Accepted: April 23, 2015 Published: August 05, 2013
Citation: Casazza F, Bongarzoni A, Guenzati G, Tassinario G, Mafrici A (2015) Fulminant Pulmonary Embolism Successfully Treated with Thrombolysis. Analg Resusc: Curr Res 4:1. doi:10.4172/2324-903X.1000133


 Fulminant Pulmonary Embolism Successfully Treated with Thrombolysis

A 70 year-old man, with a history of major depression and arterial hypertension, was admitted to the emergency department for severe hypotension and suspected abuse of anti anxiety drugs. Due to the rapid deterioration of his clinical conditions a bed-side echocardiography was rapidly performed,that was compatible with acute pulmonary embolism. During echocardiography, the patient developed a pulseless electrical activity with residual cardiac contractility (pseudo PEA) that evolved into pulseless electrical activity without cardiac contractility (true PEA). After 20 minutes of cardiopulmonary resuscitation (CPR), empirical alteplase 50 mg + 50 mg was administered intravenously over 5 minutes, with restoration of spontaneous circulation. PE was confirmed by computed tomographic angiography. His hospital stay was complicated by non-hemorrhagic neurological impairment that resulted in quadriplegia.

Keywords: Pulmonary embolism; Echocardiography; Cardiorespiratory arrest; Cardiopulmonary resuscitation; Alteplase

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