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PE with ST-segment elevation in leads V1-3and AVR treated successfully by catheter directed high-dose bolus thrombolytic therapy during CPR
Ist Teil von
The American journal of emergency medicine, 2014-12, Vol.32 (12), p.1557.e1
Ort / Verlag
Philadelphia: Elsevier Limited
Erscheinungsjahr
2014
Link zum Volltext
Quelle
Elsevier ScienceDirect Journals Complete
Beschreibungen/Notizen
While waiting for a cardiac troponin and other laboratory tests ordered to confirm the suspected diagnosis of acute coronary syndrome, abruptly, the patient went into cardiopulmonary arrest secondary to ventricular fibrillation. While waiting for a cardiac troponin and other laboratory tests ordered to confirm the suspected diagnosis of acute coronary syndrome, abruptly, the patient went into cardiopulmonary arrest secondary to ventricular fibrillation. Recombinant tissue plasminogen activator (rt-PA) bolus (25 mg) was given immediately in the PA after the definite diagnosis, but the patient did not achieve hemodynamic stability. [...]25 mg rt-PA bolus was administered again in the PA about 5 minutes later. The patient survived after prolonged intensive care treatment without severe bleeding complications and did not he present any neurologic deficit. [...]25 mg rt-PA bolus was administered again in the PA about 5 minutes later. Herein, we gave bolus (25 mg) rt-PA twice directly into PA by pig-tail catheter because after the first bolus, the patient did not achieve hemodynamic stability. Since we had no percutaneus intervention device for fragmentation or aspiration of thrombus, the second bolus was given and a successful angiographic image and a hemodynamic result were obtained.