A case of Large saddle pulmonary embolism in a woman infecte
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A 50-year-old woman was admitted to the Accident & Emergency department of Baqiyatallah hospital in Tehran (Iran), with symptoms of fever, dyspnoea, dry cough, and fatigue for the past 4 days.

At physical examination, she had enhanced body temperature (38.1 °C), a heart rate of 100 b.p.m., a respiratory rate of 22 breaths/min, and O2 saturation of 92%. Laboratory tests revealed an increased white blood cell count, increased platelets, polynuclear; partial thromboplastin time, PTLab/INRLab; prothrombin test; and D-dimer. Further elevated values were found for C-reactive protein, erythrocyte sedimentation rate; serum glutamic-pyruvic transaminase; lactate dehydrogenase; and amylase serum. Reverse transcription–PCR for COVID-19 was positive and the patient was given oxygen and treated with hydroxychloroquine, dimenhydrinate, and naproxen.

On day 2 after admission, a chest CT scan without contrast evidenced bilateral diffuse multiple patchy and subpleural consolidations with left pleural effusion—radiological findings consistent with COVID-19 pneumonia. On day 3 following admission, the patient suddenly developed severe dyspnoea, with O2 saturation decreasing to 74%. A chest computed tomography angiography (CTA) was performed, which revealed a large saddle pulmonary embolism in the main pulmonary artery (MPA), right pulmonary artery (RPA), and left pulmonary artery (LPA). From day 3 of hospitalization, the patient received anticoagulation therapy with heparin and antithrombotic treatment.

The patient remained in hospital for a further 7 days before being discharged in stable condition, with O2 saturation increased to 98%, body temperature of 37.2 °C, negative PCR, and normal laboratory tests.

Source: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaa402/5831089
Dr. S●●●●y M●●●●●●●●i and 6 others like this
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