Document Detail

Successful treatment of massive pulmonary embolism in a pregnant woman, with low-dose, slow infusion of tissue plasminogen activator.
MedLine Citation:
PMID:  20215840     Owner:  NLM     Status:  MEDLINE    
Pulmonary embolism (PE) is an important cause of morbidity and mortality during pregnancy. A 21-year-old pregnant woman presented with chest pain and progressive shortness of breath at 35 weeks of gestation. Her respiratory rate was 26 breaths/min. Electrocardiography showed sinus tachycardia and nonspecific ST-T changes. Her plasma D-dimer level was elevated (1,325 ng/ml). Transthoracic echocardiography revealed enlargement of the right ventricle and a large, highly mobile thrombus in the right atrium moving during diastole into the right ventricle. Doppler ultrasonography of the lower extremities showed bilateral acute deep femoral vein thrombosis. Following the diagnosis of right heart thrombosis with massive PE, low-dose and prolonged infusion of tissue-type plasminogen activator (25 mg in three hours) was administered. Echocardiography performed six hours after thrombolysis showed a significant decrease in the right ventricular size and complete lysis of the thrombus in the right heart. Thrombosis risk panel studies showed factor V Leiden homozygote mutation. A live newborn was delivered by cesarean section at 37 weeks of gestation. No complications were seen during a 6-month follow-up.
Murat Biteker; Nil?fer Ek?i Duran; Mehmet Ozkan
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  T?rk Kardiyoloji Derne?i ar?ivi : T?rk Kardiyoloji Derne?inin yay?n organ?d?r     Volume:  38     ISSN:  1016-5169     ISO Abbreviation:  Turk Kardiyol Dern Ars     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-03-10     Completed Date:  2010-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9426239     Medline TA:  Turk Kardiyol Dern Ars     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  32-4     Citation Subset:  IM    
Department of Cardiology, Kartal Ko?uyolu Heart and Research Hospital, Istanbul, Turkey.
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MeSH Terms
Cesarean Section
Femoral Vein / ultrasonography
Heart Murmurs / ultrasonography
Infant, Newborn
Pregnancy Complications / ultrasonography*
Pulmonary Embolism / ultrasonography*
Thrombolytic Therapy
Tissue Plasminogen Activator / therapeutic use*
Treatment Outcome
Ultrasonography, Doppler
Venous Thrombosis / ultrasonography
Young Adult
Reg. No./Substance:
EC Plasminogen Activator

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