Pulseless electrical activity in acute massive pulmonary embolism during thrombolytic therapy
We report a case of acute pulmonary embolism with hemodynamic instability diagnosed by a computed tomography pulmonary angiogram. The patient developed pulseless electrical activity during systemic thrombolytic therapy with recombinant tissue plasminogen activator. Successful return of spontaneous c...
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Tzu-Chi Medical Journal |
| Subjects: | |
| Online Access: | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2017;volume=29;issue=1;spage=50;epage=54;aulast=Yu |
| _version_ | 1818250558060888064 |
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| author | Han-Hua Yu Jing-Ren Jeng |
| author_facet | Han-Hua Yu Jing-Ren Jeng |
| author_sort | Han-Hua Yu |
| collection | DOAJ |
| description | We report a case of acute pulmonary embolism with hemodynamic instability diagnosed by a computed tomography pulmonary angiogram. The patient developed pulseless electrical activity during systemic thrombolytic therapy with recombinant tissue plasminogen activator. Successful return of spontaneous circulation was achieved after immediate cardiopulmonary resuscitation with chest compressions for 6 min. His electrocardiogram (ECG) on arrival in the emergency department displayed sinus tachycardia, an S wave in lead I, a Q wave in lead III, incomplete right bundle branch block (RBBB), T-wave inversion (TWI) in leads V1–V3, ST elevation in leads aVR and V1, and ST depression in leads I, II, III, aVF, and V4–V6. These characteristic ECG changes might have prognostic value for clinical deterioration. He recovered after treatment. After discharge, the ECG showed resolution of TWI in leads V1–V3 and incomplete RBBB, suggesting recovery from right ventricular dysfunction, which was confirmed by an echocardiogram on follow in the outpatient department. |
| first_indexed | 2024-12-12T15:54:17Z |
| format | Article |
| id | doaj.art-0b57c80a808c4f1c8e8b55e8d652bea3 |
| institution | Directory Open Access Journal |
| issn | 1016-3190 2223-8956 |
| language | English |
| last_indexed | 2024-12-12T15:54:17Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Tzu-Chi Medical Journal |
| spelling | doaj.art-0b57c80a808c4f1c8e8b55e8d652bea32022-12-22T00:19:32ZengWolters Kluwer Medknow PublicationsTzu-Chi Medical Journal1016-31902223-89562017-01-01291505410.4103/tcmj.tcmj_7_17Pulseless electrical activity in acute massive pulmonary embolism during thrombolytic therapyHan-Hua YuJing-Ren JengWe report a case of acute pulmonary embolism with hemodynamic instability diagnosed by a computed tomography pulmonary angiogram. The patient developed pulseless electrical activity during systemic thrombolytic therapy with recombinant tissue plasminogen activator. Successful return of spontaneous circulation was achieved after immediate cardiopulmonary resuscitation with chest compressions for 6 min. His electrocardiogram (ECG) on arrival in the emergency department displayed sinus tachycardia, an S wave in lead I, a Q wave in lead III, incomplete right bundle branch block (RBBB), T-wave inversion (TWI) in leads V1–V3, ST elevation in leads aVR and V1, and ST depression in leads I, II, III, aVF, and V4–V6. These characteristic ECG changes might have prognostic value for clinical deterioration. He recovered after treatment. After discharge, the ECG showed resolution of TWI in leads V1–V3 and incomplete RBBB, suggesting recovery from right ventricular dysfunction, which was confirmed by an echocardiogram on follow in the outpatient department.http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2017;volume=29;issue=1;spage=50;epage=54;aulast=YuAcute pulmonary embolismCardiopulmonary resuscitationElectrocardiographyPulseless electric activityThrombolytic therapy |
| spellingShingle | Han-Hua Yu Jing-Ren Jeng Pulseless electrical activity in acute massive pulmonary embolism during thrombolytic therapy Tzu-Chi Medical Journal Acute pulmonary embolism Cardiopulmonary resuscitation Electrocardiography Pulseless electric activity Thrombolytic therapy |
| title | Pulseless electrical activity in acute massive pulmonary embolism during thrombolytic therapy |
| title_full | Pulseless electrical activity in acute massive pulmonary embolism during thrombolytic therapy |
| title_fullStr | Pulseless electrical activity in acute massive pulmonary embolism during thrombolytic therapy |
| title_full_unstemmed | Pulseless electrical activity in acute massive pulmonary embolism during thrombolytic therapy |
| title_short | Pulseless electrical activity in acute massive pulmonary embolism during thrombolytic therapy |
| title_sort | pulseless electrical activity in acute massive pulmonary embolism during thrombolytic therapy |
| topic | Acute pulmonary embolism Cardiopulmonary resuscitation Electrocardiography Pulseless electric activity Thrombolytic therapy |
| url | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2017;volume=29;issue=1;spage=50;epage=54;aulast=Yu |
| work_keys_str_mv | AT hanhuayu pulselesselectricalactivityinacutemassivepulmonaryembolismduringthrombolytictherapy AT jingrenjeng pulselesselectricalactivityinacutemassivepulmonaryembolismduringthrombolytictherapy |