Key result
Catheter-directed treatment and anticoagulation rescue a patient with massive PE presenting as seizures and arrest.
Why the study?
Seizure as the presentation of massive pulmonary embolism is extremely rare, with no prior reports of successful percutaneous catheter-based treatment for this presentation with cardiac arrest.
Can percutaneous catheter-directed anticoagulant therapy successfully treat massive pulmonary embolism presenting with seizures and cardiac arrest?
Case Report (n=1)
Can percutaneous catheter-directed anticoagulant therapy successfully treat massive pulmonary embolism presenting with seizures and cardiac arrest?
Massive pulmonary embolism should be considered in the differential diagnosis for patients presenting with new-onset seizures and hemodynamic instability, and can be successfully managed with catheter-directed therapy.
May warrant considering massive PE in new-onset seizures with arrest; leaves open role of catheter-directed therapy.
Massive pulmonary embolism (MPE) is a high-risk medical emergency. Seizure as the clinical presentation of MPE is extremely rare, and to our knowledge, there have been no reports on successful percutaneous, catheter-based treatment of MPE presenting with new-onset seizures and cardiac arrest. In this report, we discuss the case of a 64-year-old woman who presented with an episode of seizure that lasted 5 h. Seizure occurred four times within 12 h after arrival at the hospital, and in the end, she sustained a cardiac arrest. The patient had no past history of seizure or cardiopulmonary disease. Bilateral MPE was detected by a computed tomography pulmonary angiogram, and she was successfully treated with percutaneous, catheter-directed anticoagulant therapy. Pulmonary embolism-related seizures are more difficult to diagnose and have higher mortality rates than seizures. MPE should be suspected in patients presenting with new-onset seizures and hemodynamic instability.
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Leong et al. (2022) conducted a case report in Massive pulmonary embolism presenting with seizure (n=1). Percutaneous catheter-directed treatment (CDT) and anticoagulation was evaluated on Clinical recovery and survival. A 64-year-old woman presenting with new-onset seizures and cardiac arrest due to massive pulmonary embolism was successfully treated with percutaneous catheter-directed treatment and anticoagulation.
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