Thorac Cardiovasc Surg 2014; 62(01): 085-088
DOI: 10.1055/s-0032-1331286
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Pulmonary Embolism in Deceivingly Stable Patients with High Thrombus Load—When Is Stable Really Safe?

Philipp M. Lepper
1   Department of Internal Medicine V, University Hospital of Saarland, Homburg, Germany
,
Heinrike Wilkens
1   Department of Internal Medicine V, University Hospital of Saarland, Homburg, Germany
,
Andreas Link
2   Department of Internal Medicine III, University Hospital of Saarland, Homburg, Germany
,
Robert Bals
1   Department of Internal Medicine V, University Hospital of Saarland, Homburg, Germany
,
Hans-Joachim Schäfers
3   Department of Thoracic and Cardiovascular Surgery, University Hospital of Saarland, Homburg, Germany
› Author Affiliations
Further Information

Publication History

07 February 2012

21 May 2012

Publication Date:
20 February 2013 (online)

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Abstract

The definitive treatment of hemodynamically stable patients with pulmonary embolism and echocardiographically proven moderate to severe right ventricular dysfunction is unclear. We discuss the cases of a 45-year-old woman and a 62-year-old man that fulfilled the above criteria, but had a high risk for adverse events. Although both patients were treated according to current guidelines, one underwent successful surgical embolectomy the same day and the other was resuscitated a few days later. Surgery is an alternative for carefully selected patients with mild right ventricular dysfunction, but a high risk for adverse events that would otherwise be treated the same way as low- to moderate-risk patients.

 
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