Saddle Pulmonary Embolism with Normal Right Ventricular Function: A Treatment Enigma

Daher, Iyad N.; Bathina, Jaya; Bukhari, Farhan; Yusuf, Salim

doi:10.1258/shorts.2009.090357

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…The diagnosis of saddle PE causes clinical alarm because it signals an unstable, large clot burden in the pulmonary artery and the possibility of sudden haemodynamic collapse. Nonetheless, the clinical presentation and outcomes of these patients vary widely [9][10][11][12][13]. In particular, an unresolved issue is the prognosis of patients with SE in haemodynamically stable (non-high-risk) PE.…”

Section: Advances In Knowledgementioning

confidence: 99%

The impact of saddle embolism on the major adverse event rate of patients with non-high-risk pulmonary embolism

Kwak

Kim²,

Lee³

et al. 2013

BJR

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Objective: Wider application of CT angiography (CTA) improves the diagnosis of acute pulmonary embolism (PE). It also permits the visualisation of saddle embolism (SE), namely thrombi, which are located at the bifurcation of the main pulmonary artery. The aim of this study was to assess the prevalence of SE and whether SE predicts a complicated clinical course in patients with non-high-risk PE. Methods: In total, 297 consecutive patients with non-highrisk PE confirmed using CTA in the emergency department were studied. The presence of SE and its ability to predict the occurrence of major adverse events (MAEs) within 1 month were determined.

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Section: Advances In Knowledgementioning

confidence: 99%

The impact of saddle embolism on the major adverse event rate of patients with non-high-risk pulmonary embolism

Kwak

Kim²,

Lee³

et al. 2013

BJR

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“…One determinant of mortality and the need for possible surgical embolectomy when evaluating PE is right ventricular (RV) function. As many as 45% of individuals with saddle PE are hemodynamically stable, and RV strain has prognostic value in both stable and unstable patients [4]. Individuals demonstrating RV strain or instability can benefit from systemic thrombolytics or mechanical thrombectomy.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Management of Saddle Pulmonary Embolism in a High-Risk Patient With COVID-19

Biggs¹,

Bell²,

Park³

2022

Cureus

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A pulmonary embolism (PE) that is located in the main pulmonary artery is known as a saddle pulmonary embolism. Individuals at high risk who become unstable often require surgical intervention or more aggressive management with thrombolytic therapy. COVID-19 is a known risk factor for a hypercoagulable state and therefore increases the risk of PE and its associated complications. Individuals hospitalized with the COVID-19 virus and who have evidence of right ventricular dysfunction with PE are found to have a significantly higher risk of mortality. We present a case of an individual with several high-risk factors for PE as well as COVID-19 infection and evidence of cardiac strain, making the decision for treatment less clear. He was, however, treated successfully with heparin and enoxaparin alone. Furthermore, our case had resolving symptoms of COVID-19, highlighting the importance of high clinical suspicion for PE in those diagnosed with COVID-19.

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Saddle Pulmonary Embolism with Normal Right Ventricular Function: A Treatment Enigma

Cited by 2 publications

References 15 publications

The impact of saddle embolism on the major adverse event rate of patients with non-high-risk pulmonary embolism

The impact of saddle embolism on the major adverse event rate of patients with non-high-risk pulmonary embolism

Pharmacological Management of Saddle Pulmonary Embolism in a High-Risk Patient With COVID-19

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