October 2014 pulmonary case of the month: a big clot

Abstract

No abstract available. Article truncated after 150 words. History of Present Illness: A 63 year-old man was brought to the emergency department (ED) with a report of acute onset of dyspnea. The dyspnea had started at rest less than one hour prior to ED presentation. It quickly progressed to severe respiratory distress. His initial vital signs were recorded as a BP of 124/69, pulse of 112, respiratory rate of 26 with an oxygen saturation (SpO2) of 88% on 15 liters per minute (lpm) of oxygen via a non-rebreather mask. He was placed on non-invasive ventilation with intermittent episodes of brief desaturation into the 60% range. He was subsequently intubated without incident. Immediately following intubation he experienced a pulseless electrical activity (PEA) cardiopulmonary arrest. Past Medical History: Diabetes mellitus, Coronary Artery Disease, Hypertension, Deep Venous Thrombosis. Past Surgical History: Coronary Artery Bypass Graft – 2 vessel. Medications: Atorvastatin 40mg PO daily, Insulin glargine 10u SQ daily, Lisinopril 10mg PO daily ...

Keywords

• pulmonary embolism
• pulmonary embolus
• PE
• CT scan
• treatment
• tPA
• tissue plasminogen activator
• IVC filter
• Greenfield filter
• hypercoaguable state