Managing Acute Intermediate Risk Pulmonary Thromboembolism in a Patient Who Developed Heparin-Induced Thrombocytopenia: Review of Current Guidelines and Literature.
Blerina AsllanajElizabeth BengeSapna BhatiaYi McWhorterPublished in: Journal of investigative medicine high impact case reports (2023)
Intermediate-risk pulmonary embolism describes hemodynamically stable patients with evidence of right ventricular strain, whereas high-risk pulmonary embolism comprises hemodynamic decompensation resulting in cardiogenic shock. The clinical manifestations of the two aforementioned conditions are challenging to treat in the setting of heparin-induced thrombocytopenia (HIT). Without immediate therapeutic anticoagulation, patients can subsequently deteriorate and require additional advanced therapies, with the end-goal of restoring pulmonary artery perfusion. We present the case of a male with bilateral intermediate-risk pulmonary emboli who developed type 2 HIT prompting different selection of appropriate management strategies.
Keyphrases
- pulmonary embolism
- pulmonary artery
- pulmonary hypertension
- inferior vena cava
- venous thromboembolism
- coronary artery
- end stage renal disease
- magnetic resonance imaging
- ejection fraction
- high glucose
- case report
- diabetic rats
- chronic kidney disease
- intensive care unit
- atrial fibrillation
- respiratory failure
- prognostic factors
- computed tomography
- stress induced