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J Korean Soc Emerg Med > Volume 23(4); 2012 > Article
Journal of The Korean Society of Emergency Medicine 2012;23(4): 551-554.
A Massive Pulmonary Embolism with Hemodynamically Unstable Stroke Symptoms
Chan Young Koh, Young Soon Cho, Ho Jung Kim
Department of Emergency Medicine, College of Medicine, Soonchunhyang University, Bucheon, Korea. choyoungsoon@hanafos.com
ABSTRACT
Pulmonary embolisms account for 13~25% of early deaths after stroke. Early diagnosis and appropriate management of thrombolysis are important, however, diagnosis is often difficult, and the consequences for patients can be severe. Echocardiography is useful for evaluation for massive pulmonary embolism, particularly in hemodynamically unstable patients. We report on a case involving a 67-year-old female patient in severe hemodynamic compromise, with an altered mental status and hemiparesis. Findings on brain computerized tomography (CT) showed acute infarction at the left middle cerebral artery territory and transthoracic echocardiography indicated a massive pulmonary embolism. Despite administration of conservative management, the patient died due to a cerebral complication.
Key words: Stroke, Pulmonary embolism, Echocardiography, Thrombolytic therapy
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