Catheter-directed thrombolysis in a case of postpartum acute intermediate-high risk pulmonary embolism Cover

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Catheter-directed thrombolysis in a case of postpartum acute intermediate-high risk pulmonary embolism

Romanian Journal of Cardiology

Volume 35 (2025): Issue 2 (June 2025)

By: Laurentiu Huma, Laszlo Hadadi, Raluca Pata and Silvia Lupu

Open Access

|Jun 2025

Figures & Tables

Diagnostic tests before treatment decision. a. Electrocardiogram in the Emergency Department (V-25mm/sec, A-10mm/mV) depicting sinus tachycardia, right ventricular strain, and S1Q3T3 (McGinn-White) pattern. b. Computed tomography pulmonary angiography showing the obstruction of the pulmonary arteries (arrows). c-e. Echocardiographic images registered in the Cardiology Ward, showing a reduced (15.5 mm) tricuspid annular plane systolic excursion (TAPSE) measured by M-mode (c), a severely reduced pulmonary artery acceleration time (69 msec), with a mid-systolic notch (d), and the flattening of the interventricular septum due to the increased right ventricular pressure (e).

Digital subtraction pulmonary artery angiography and invasive right heart pressure recordings before and after catheter-directed thrombolysis. a. Multiple thrombi obstructing completely/partially the left and right pulmonary artery branches before thrombolysis. b. Improved angiographic appearance at the level of almost any of the lobar arteries at the end of thrombolysis; however, clots still can be identified at multiple sites. c-d. Right ventricular pressure tracings at the beginning and at the end of thrombolysis: the systolic pressure dropped from 55 to 35 mmHg. e-f. Similarly, the mean pulmonary artery pressure decreased from 31 to 19 mmHg. The embedded image (g) shows the two pigtail catheters positioned in the right and left pulmonary arteries at the beginning of the treatment.

DOI: https://doi.org/10.2478/rjc-2025-0009 | Journal eISSN: 2734-6382 | Journal ISSN: 1220-658X

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Language: English

Page range: 142 - 147

Published on: Jun 30, 2025

Published by: Romanian Society of Cardiology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

pulmonary embolism,

postpartum status,

oral anticoagulation,

catheter directed thrombolysis,

pharmacological treatment

Related subjects:

Clinical medicine,

Internal medicine,

Cardiac surgery,

Pediatrics and juvenile medicine,

Paediatric cardiology

© 2025 Laurentiu Huma, Laszlo Hadadi, Raluca Pata, Silvia Lupu, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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