首页 | 本学科首页   官方微博 | 高级检索  
检索        


High-Risk Pulmonary Embolism During Labor: JACC Patient Care Pathways
Institution:1. Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA;2. The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA;3. Department of Cardiovascular Sciences, Guys and St Thomas NHS Trust, Long, United Kingdom;4. University of Minnesota, Minneapolis, Minnesota, USA;5. Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA;6. Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA;1. Center for Advanced Heart Disease, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA;2. Department of Medical Imaging, Montreal Heart Institute, Montreal, Quebec, Canada;1. Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA;2. Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA;3. Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA;4. Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA;5. Minneapolis Heart Institute, Abbott Northwestern Hospital, and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA;6. Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York, USA;7. Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA;8. Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA;9. Department of Laboratory Medicine and Pathology, Hennepin Healthcare/HCMC, Minneapolis, Minnesota, USA;10. Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA;11. Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, California, USA;12. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA;13. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA;14. Heart Failure and Biomarker Trials, Baim Institute for Clinical Research, Boston, Massachusetts, USA;1. Cardiovascular Division, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA;2. The Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai Health, New York, New York, USA;1. Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA;2. Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania, USA;3. Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA;4. Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA;5. Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Hufelandstraße, Essen, Germany;6. Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA;7. Parkview Mirro Center for Research and Innovation, Parkview Health, Fort Wayne, Indiana, USA;8. Department of BioHealth Informatics, Indiana University–Purdue University Indianapolis School of Informatics and Computing, Indianapolis, Indiana, USA;9. Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA;10. Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom;11. National Heart and Lung Institute, Imperial College, London, United Kingdom;1. Division of Cardiology, Department of Medicine, University of California Los Angeles (UCLA) Medical Center, Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, California, USA;2. UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California, USA;3. Division of Cardiology, Department of Pediatrics, UCLA Medical Center, Los Angeles, California, USA;4. McGill Adult Unit for Congenital Heart Disease Excellence, Division of Cardiology, McGill University, Montreal, Quebec, Canada;5. Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA;6. Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia;7. Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Stanford, California, USA;8. Division of Cardiology, Peter Munk Cardiac Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada;9. Department of Internal Medicine and Pediatrics, Johns Hopkins University, Baltimore, Maryland, USA;10. Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada;11. Mount Sinai Adult Congenital Heart Disease Center, Mount Sinai Cardiovascular Institute and The Children’s Heart Center, Mount Sinai Kravis Children’s Hospital, New York, New York, USA;12. Children’s Heart Centre, 2nd Faculty of Medicine Charles University in Prague and Motol University Hospital, Prague, Czech Republic;13. Freeman Hospital Cardiothoracic Centre, Newcastle upon Tyne, Tyne and Wear, United Kingdom;14. Division of Pediatric Cardiology and Pediatric Critical Care Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai and Kravis Children’s Hospital at Mount Sinai, Mount Sinai Medical Center, New York, New York, USA;15. Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida, USA;p. Vanderbilt University Medical Center, Nashville, Tennessee, USA;q. Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA;r. Department of Cardiology, Royal Brompton and Harefield Hospital, Royal Brompton and Harefield NHS Trust, Imperial College London, London, United Kingdom;s. Department of Cardiology, Heart Center, Amsterdam University Medical Centers/University of Amsterdam, Amsterdam, the Netherlands;t. Division of Cardiology, Inova Children’s Hospital, Fairfax, Virginia, USA
Abstract:While in labor, a 37-year-old woman developed acute dyspnea, hypoxemia, and tachycardia. Transthoracic echocardiography demonstrated severe right ventricular dilation and dysfunction, raising the suspicion of acute pulmonary embolism. The patient indeed had bilateral pulmonary embolism, necessitating percutaneous thrombectomy. Her course was complicated by another saddle pulmonary embolus, heparin-induced thrombocytopenia, and COVID-19 infection. This clinical case illustrates the importance of prompt diagnosis of acute pulmonary embolism in a peripartum female patient, the multidisciplinary approach of management, and how to approach clinical complications such as heparin-induced thrombocytopenia. Furthermore, long-term management in acute pulmonary embolism is presented.
Keywords:multimodality imaging  pregnancy  pulmonary embolism  CT"}  {"#name":"keyword"  "$":{"id":"kwrd0030"}  "$$":[{"#name":"text"  "_":"computed tomography  CTA"}  {"#name":"keyword"  "$":{"id":"kwrd0040"}  "$$":[{"#name":"text"  "_":"computed tomography angiogram  CTPA"}  {"#name":"keyword"  "$":{"id":"kwrd0050"}  "$$":[{"#name":"text"  "_":"computed tomography pulmonary angiography  ECMO"}  {"#name":"keyword"  "$":{"id":"kwrd0060"}  "$$":[{"#name":"text"  "_":"extracorporeal membrane oxygenation  HIT"}  {"#name":"keyword"  "$":{"id":"kwrd0070"}  "$$":[{"#name":"text"  "_":"heparin-induced thrombocytopenia  LV"}  {"#name":"keyword"  "$":{"id":"kwrd0080"}  "$$":[{"#name":"text"  "_":"left ventricle  PE"}  {"#name":"keyword"  "$":{"id":"kwrd0090"}  "$$":[{"#name":"text"  "_":"pulmonary embolism  PVR"}  {"#name":"keyword"  "$":{"id":"kwrd0100"}  "$$":[{"#name":"text"  "_":"pulmonary vascular resistance  RV"}  {"#name":"keyword"  "$":{"id":"kwrd0110"}  "$$":[{"#name":"text"  "_":"right ventricle  SBP"}  {"#name":"keyword"  "$":{"id":"kwrd0120"}  "$$":[{"#name":"text"  "_":"systolic blood pressure  TTE"}  {"#name":"keyword"  "$":{"id":"kwrd0130"}  "$$":[{"#name":"text"  "_":"transthoracic echocardiogram
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号