Central venous catheter use in a morbidly obese patient resulted in extensive venous thrombosis and subsequent cor pulmonale, highlighting the increased thrombotic risk in this population.
Case Report (n=1)
Introduction: Sometimes the needless usage of central venous catheter, conflicting with indications, has been witnessed. Unfortunately, incidence of axillary-subclavian venous thrombosis has risen gradually because of increased use of the subclavian vein for central venous access. Furthermore obesity is common among patients with deep vein thrombosis, with a prevalence of 20-25%. Presentation of Case: I am presenting a 35-year old morbidly-obese woman with cor pulmonale resulting from post-catheterization thrombosis of jugular, axillary, subclavian veins, and superior vena cava. Discussion: Obese individuals have higher levels of factor VIII and factor IX. Obesity promotes deep vein thrombosis by inducing plasma viscosity and erythrocyte aggregation as well. Obesity causes, via leptin, increasing activity of coagulation cascade and decreasing fibrinolysis. Also it increases inflammation, oxidative stress and endothelial dysfunction. Obesity together with central venous catheter use may increase the risk for the development of deep vein thrombosis and subsequent cor pulmonale. Conclusion: Requirement of central venous catheter must be reconsidered before introducing, especially in an obese patient.
Aşkın Ender Topal (Fri,) conducted a case report in Cor pulmonale resulting from post-catheterization thrombosis (n=1). Central venous catheter was evaluated on Development of deep vein thrombosis and subsequent cor pulmonale. Central venous catheter use in a morbidly obese patient resulted in extensive venous thrombosis and subsequent cor pulmonale, highlighting the increased thrombotic risk in this population.
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