Managing Acute Intermediate Risk Pulmonary Thromboembolism in a Patient Who Developed Heparin-Induced Thrombocytopenia: Review of Current Guidelines and Literature.

1 例发生肝素诱导的血小板减少症患者急性中等风险肺血栓栓塞症的管理 ： 当前指南和文献综述.

• 发表时间: Jan-Dec 2023
• 来源期刊: J Investig Med High Impact Case Rep
• DOI: 10.1177/23247096231166673
• PMID: 37032594
• 文章类型: Case Reports
• 作者列表: Asllanaj B,Benge E,Bhatia S,McWhorter Y

关键词: cardiology; pulmonary critical care

Mesh: Humans; Male; Heparin / adverse effects; Pulmonary Embolism / drug therapy; Thrombocytopenia / chemically induced drug therapy; Acute Disease

Abstract

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.

摘要

中危肺栓塞描述了血流动力学稳定的患者，有右心室劳损的证据，而高危肺栓塞包括导致心源性休克的血流动力学代偿失调。在肝素诱导的血小板减少症（HIT）的情况下，上述两种疾病的临床表现对治疗具有挑战性。如果没有立即治疗性抗凝，患者随后可能会恶化，需要额外的先进疗法，最终目标是恢复肺动脉灌注。我们介绍了一名患有双侧中危肺栓塞的男性，其发展为2型HIT，促使人们选择不同的管理策略。