- Home
- Search Results
Search Results
Filter :
FILTER BY keyword:
FILTER BY author:
FILTER BY date:
FILTER BY language:
FILTER BY content type:
FILTER BY publication:
FILTER BY affiliation:
- Department of Hematology, Hamad Medical Corporation, Qatar [1]
- Department of Internal Medicine, Hamad Medical Corporation, Qatar Email: [email protected] [1]
- Department of Internal Medicine, New York Medical College/Metropolitan Hospital Center, New York, USA [1]
- Department of Medical ICU, Hamad Medical Corporation, Qatar [1]
FILTER BY article type:
FILTER BY access type:
Dilemma of Thrombolysis in a patient with high-risk Pulmonary Embolism with severe Thrombocytopenia: A case report
Background: Managing a high-risk pulmonary embolism (PE) in a critically ill patient with severe thrombocytopenia can present a challenging dilemma. There is a high risk of fatal bleeding due to anticoagulation in high-risk PE with thrombocytopenia; therefore risks and benefits are balanced while dealing with such a critical scenario.
Case Report: We present a case of a female patient with thrombocytopenia who was admitted for management of lymphoma. Her hospital course was complicated by high-risk PE leading to acute respiratory failure and hypotension necessitating urgent transfer to the medical intensive care unit. She was intubated and placed on mechanical ventilation. Multiple cardiac arrests occurred due to compromised cardiac output from a severely dilated right ventricle on bedside transthoracic echocardiography. As a last resort to save her life in this critical state and severe thrombocytopenia she was given a half bolus dose of the recommended drug i.e. 50mg IV of Alteplase. Subsequently she stabilized and was extubated without any further complications.
Discussion: High-risk PE needs prompt management with anticoagulation to avoid fatal outcomes. However on the other hand anticoagulation carries a high risk of bleeding especially in patients with thrombocytopenia. These challenges prompt a modern perspective in situations where clear guidelines are absent.
Conclusion: We aim to discuss our contemporary clinical practice in managing such a complex case and highlight the need for further studies.