Authors: M Forkmann S M Tugtekin R H Strasser H Schrötter
Publish Date: 2012/02/02
Volume: 101, Issue: 6, Pages: 497-498
Abstract
A 77yearold woman was admitted with progressive dyspnea at rest in a local hospital She complained of acute onset of shortness of breath during a walk Hypertension hyperlipidemia and hypothyroidism were medically treated She had a history of deep vein thrombosis At admission the patient was anxious and sweaty her extremities were cold an initial hypoxemia PaO265 kPa accompanied by a desaturation 83 were detected A swelling on the left side of the lower leg was striking The chest Xray showed no signs of infiltration pleura effusion or pulmonary congestion Following the suspicion of pulmonary embolism PE a transthoracic echocardiography was performed immediately The echo showed a severe pulmonary hypertension RVSP 70 mmHg accompanied by an acute dilation of the right ventricle 36 mm Surprisingly a large mass 24 × 12 mm suggestive of a thrombus could be seen in the right atrium Doppler ultrasounds of the lower limbs revealed a thrombosis of the
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