Intra-arrest thrombolysis in pulmonary thromboembolia with a successful clinical and neurological outcome: a case report

Abstract

Pulmonary thromboembolism is a highly fatal entity, and usually presents atypically. Between 80 and 90% of cases of cardiorespiratory arrest secondary to pulmonary embolism occur between 1 and 3hours after the onset of symptoms, requiring a high degree of clinical suspicion as patient management and prognosis will depend on this. We present the case of a 72-year-old man, admitted after gastrointestinal symptoms and syncope, and who presented cardiorespiratory arrest while in the emergency room. Prior to the circulatory arrest, signs of right ventricular dysfunction and intracavitary thrombi were documented, so systemic thrombolysis was administered overall during resuscitation maneuvers. Subsequently the patient evolved successfully with no cardiac or neurological dysfunction.