Key result
Thrombolysis and simultaneous RCA thrombectomy successfully treat rare concomitant PE and inferior STEMI.
Case Report (n=1)
Early recognition and simultaneous treatment with thrombolysis and thrombectomy can be life-saving in rare cases of concomitant pulmonary embolism and STEMI due to paradoxical embolism.
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Supports combined thrombolysis-thrombectomy in rare concomitant PE-STEMI; leaves open optimal protocols pending prospective data.
Concomitant acute myocardial infarction (MI) and pulmonary embolism (PE) is exceedingly rare. However, establishing the diagnosis early is essential, since delay in treating the patient may lead to a potential fatal outcome. Right ventricular (RV) infarction in the setting of inferior ST-segment elevation MI (STEMI), coupled with acute massive PE confers particular risk due acute RV failure and low cardiac output, threatening survival. We report a rare case of concomitant PE and inferior STEMI in a 43-year-old woman with a history of acute chest pain. She was haemodynamically compromised, with Type I respiratory failure but lack of signs of heart failure. Early recognition of dual pathologies prompted administration of thrombolytic therapy and simultaneous right coronary artery thrombectomy to treat PE and STEMI. Prompt clinical diagnosis and delivery of targeted therapies adapted for the specific clinical presentation may have averted fatal outcome.
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Alkhalil et al. (2017) conducted a case report in Concomitant acute myocardial infarction and pulmonary embolism (n=1). Thrombolytic therapy and simultaneous right coronary artery thrombectomy was evaluated on Clinical outcome/survival. Early recognition and administration of thrombolytic therapy and simultaneous right coronary artery thrombectomy successfully treated a rare case of concomitant PE and inferior STEMI.
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