[HSF] Pulmonary embolism-RV dysfunction

[Justin Chan]

Hi Dr Del,

Need more information - what is the degree of RV dysfunction? CVP, PA
pressures, echo?

In my opinion (which is very junior), she should be offered an IVC
filter and anticoagulation, but in the absence of major haemodynamic
compromise would not offer embolectomy.

She should also be screened for procoagulable states-protein C, S,
factor V leiden, antithrombin III etc

I would be interested to hear how you proceed.

Regards,
Justin


On 8/2/07, yadav del <yadavluck at yahoo.com> wrote:
>
>
>    25 yrs old   female developed pulmonary embolism on 2 nd post op day after repair of incisional hernia. CT scan showed emboli at both hila .Only left lower lobe artery is spared from emboli. Duplex scan showed bilateral ilio- femoral dvt. She iss haemodynamically stable. Saturation   94% with out oxygen and 98% on 2litres oxygen. Echo showed RV dysfunction.
>
>   Should she be   offered pulmonary embolectomy in view of RV  dysfunction ?
>
>
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