A Saddle Pulmonary Embolism at Transthoracic Echocardiography: A Case Report

Wassim Beladel, M. E. Minaoui
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Abstract

Acute Pulmonary embolism (PE) is a life-threatening disease and is considered the third major cause of cardiovascular death with higher incidence and mortality rates. Identifying a saddle PE between the left and the right pulmonary trunk in transthoracic echocardiography (TTE) is rare, and helps to make a rapid diagnosis to avoid complications. Clinical presentation, electrocardiogram, and X-ray guide the diagnosis but are not specific. TTE is helpful and confirms the diagnosis especially when the CT is not available or in other situations when it is not realizable. Visualizing a pulmonary artery thrombus in TTE is unusual. It can be identified in the right cardiac chambers in less than 5% of patients with PE. The severity of acute PE is determined by its hemodynamics, the sudden pulmonary hypertension, and the development of obstructive shock. Anticoagulation therapy is the cornerstone of PE management and should be initiated as soon as possible.
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经胸超声心动图检查发现鞍状肺栓塞:病例报告
急性肺栓塞(PE)是一种危及生命的疾病,被认为是心血管疾病的第三大死因,发病率和死亡率均较高。在经胸超声心动图(TTE)中发现左肺主干和右肺主干之间的鞍状肺栓塞非常罕见,有助于快速诊断,避免并发症。临床表现、心电图和 X 光检查可指导诊断,但不具有特异性。TTE 有助于确诊,尤其是在 CT 无法使用或其他无法实现 CT 的情况下。在 TTE 中看到肺动脉血栓并不常见。只有不到 5%的 PE 患者能在右心腔发现肺动脉血栓。急性 PE 的严重程度取决于其血液动力学、突发性肺动脉高压和阻塞性休克的发展。抗凝治疗是 PE 治疗的基石,应尽快开始。
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