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Emerg Med J 2008;25:310-311 doi:10.1136/emj.2007.056390
  • Emergency casebooks

Massive pulmonary embolism with cardiac arrest treated with continuous thrombolysis and concomitant hypothermia

  1. A Hovland1,
  2. H Bjørnstad1,
  3. R F Hallstensen2,
  4. K A Hugaas3,
  5. J A Westlie4,
  6. T Elden4,
  7. K Andersen5
  1. 1
    Coronary Care Unit, Medical Department, Nordland Hospital, Bodo, Norway
  2. 2
    Department of Hematology, Nordland Hospital, Bodo, Norway
  3. 3
    Department of Radiology, Nordland Hospital, Bodo, Norway
  4. 4
    Department of Anaesthesiology, Nordland Hospital, Bodo, Norway
  5. 5
    Department of Thoracic and Cardiovascular Surgery, Rikshospitalet, Oslo, Norway
  1. Dr A Hovland, Coronary Care Unit, Medical Department, NLSH Bodo, 8092 Bodo, Norway; a-hovlan{at}online.no
  • Accepted 10 December 2007

Abstract

This case report describes the clinical course in a 49-year-old man with repeated cardiac arrests due to massive pulmonary embolism. He was successfully treated with intravenous tenecteplase followed by catheter-based alteplase infusion during external cooling. The case illustrates that vitally important bolus thrombolytic therapy may be continued as catheter-based treatment along with hypothermia without significant bleeding complications.

Footnotes

  • Funding: None.

  • Competing interests: None.

  • Patient consent: Informed consent was obtained.

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