Acute Pulmonary Thromboembolism – Use of Fibrinolysis to Treat a Hemodynamically Unstable Patient in the Era of the COVID-19 Pandemic: A Case Report

Abstract

Plućna embolija (PE) često je i potencijalno smrtonosno stanje. Usprkos napretku u dijagnostičkim postupcima, takvo se stanje često otkriva kasno ili se uopće ne otkriva. Opetovane embolije i smrt u bolesnika s PE-om mogu se spriječiti brzom dijagnozom i primjerenim liječenjem. S obzirom na to da PE ima nespecifičnu kliničku sliku i simptomatolgiju, oko trećine bolesnika nije niti dijagnosticirano niti liječeno. Znamo da postoji velika razlika u ishodima između liječenih i neliječenih bolesnika s PE-om (25 -30 % smrtnosti u neliječenih i 2 -8 % u liječenih bolesnika). Prikazujemo slučaj PE-a u odraslog bolesnika s akutno nastalom zaduhom, povraćanjem, presinkopom, boli u prsima i šokom u doba pandemije bolesti COVID-19.SUMMARY: Pulmonary embolism (PE) is a common and potentially fatal condition. Despite advances in diagnostic procedures, late detection and non-detection of this condition is also not uncommon. In patients with PE, recurrent embolisms and death can be prevented with prompt diagnosis and adequate treatment. Due to presentation with a non-specific clinical picture and symptomatology, unfortunately almost one third of the patients remain undiagnosed and untreated. We know that there is a large difference in outcome between treated and untreated patients with PE (25-30% mortality in untreated and 2-8% in treated patients). We present a case of PE in the era of the COVID-19 pandemic in an adult patient with acute dyspnea, vomiting, presyncope, chest pain, and shock.