Trombolys kan vara livräddande vid lungemboli med instabil hemodynamik. Omdiskuterad behandlingsstrategi - två fall illustrerar problemet
Engelsk titel: Thrombolysis in pulmonary embolism with unstable hemodynamics can be life-saving. Discussed treatment strategy - two cases illustrate the problem
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Författare:
Söderberg M
;
Edsberg J
Email: marten.soderberg@sodersjukhuset.se
Språk: Swe
Antal referenser: 16
Dokumenttyp:
Fallbeskrivning
UI-nummer: 08111325
Sammanfattning
Two male patients with massive pulmonary embolism are described. In the first case the signs of hemodynamic instability could not be identified and the patient did not receive thrombolytic therapy and died. In the second case these signs could be identified at an early stage and the patient received thrombolysis and could be discharged after two days with a normalized echocardiography and without dyspnoea. These two case reports discuss the importance of risk stratification in patients with massive pulmonary embolism emphasizing biomarkers, echocardiography, blood pressure and other vital signs as to identify those patients who would benefit from thrombolytic therapy. A more widespread use of echocardiography, cardiac troponins and brain natriuretic peptides (BNP) could be warranted in the emergency departments.