2015, Number 3
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CorSalud 2015; 7 (3)
Pulmonary embolism or right ventricular infarction: Clinical dilemma, apropos of a case
Hernández NM, Pérez BA, Selman-Housein BKH, Obregón SÁG, Quevedo BY, de Zayas GJ
Language: Spanish
References: 13
Page: 243-247
PDF size: 279.27 Kb.
ABSTRACT
Pulmonary embolism is a cardiovascular emergency that it is often difficult to diagnose.
The case of a 44-year-old male is reported. After an abdominal surgery, he presented
with hemodynamic instability symptoms which were interpreted as a pulmonary
thromboembolism. However, the finding of ST segment elevation in right precordial
leads stirred clinically suspicion of right ventricular infarction. The absence of
coronary lesions in the invasive coronary angiography and the evidence of pressure
overload in the right ventricle, and thrombosis of the lower limbs, corroborated the
initial diagnosis. This case emphasizes that this disease should be suspected in all patients
with suggestive symptoms, even in the presence of electrocardiographic findings
suggestive of myocardial infarction, especially in the absence of involvement of coronary circulation and echocardiographic evidence of right ventricular dysfunction
associated with signs of pulmonary hypertension.
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