PMID- 23188853
OWN - NLM
STAT- MEDLINE
DCOM- 20140121
LR  - 20211021
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 2012
DP  - 2012 Nov 27
TI  - A unique presentation of four thrombotic events at a time.
LID - 10.1136/bcr-2012-007221 [doi]
LID - bcr2012007221
AB  - A 72-year-old man was referred to our hospital as a case of postcardiac arrest 
      following a long distance air flight. Work-up in the emergency department 
      revealed the presence of deep vein thrombosis (DVT), bilateral pulmonary 
      embolism, inferior STEMI (ST elevation myocardial infarction) and ischaemic 
      stroke. He received thrombolysis by recombinant tissue plasminogen activator 
      (tPA) following which his haemodynamic status improved, but he developed 
      haemorrhagic transformation of the stroke as a complication. The haemorrhagic 
      lesion gradually resolved with conservative management, leaving behind a residual 
      neurological deficit. His haemodynamic status was stable after the management. 
      Although a diagnosis of right-to-left shunt lesion was highly suggestive in this 
      condition, it could not be confirmed on the transthoracic echocardiogram. Our 
      patient had a unique presentation of multiple thrombi in different organs that 
      caused significant morbidity and haemodynamic instability. There are no 
      well-established guidelines that discuss the acute management of such cases. This 
      situation requires a careful assessment and management of the patient by a 
      multidisciplinary team.
FAU - Rajani, Ali Raza
AU  - Rajani AR
AD  - Department of Cardiology, Rashid Hospital, Dubai Health Authority, United Arab 
      Emirates. arrajani@dha.gov.ae
FAU - Hussain, Kosar
AU  - Hussain K
FAU - Baslaib, Fahad Omar
AU  - Baslaib FO
FAU - Radaideh, Ghazi Ahmad
AU  - Radaideh GA
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20121127
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
SB  - IM
MH  - Aged
MH  - *Aircraft
MH  - Angiography
MH  - Cerebral Infarction/*diagnosis/drug therapy
MH  - Electrocardiography
MH  - Guideline Adherence
MH  - Heart Arrest/*etiology
MH  - Humans
MH  - Male
MH  - Myocardial Infarction/*diagnosis/drug therapy
MH  - Pulmonary Embolism/*diagnosis/drug therapy
MH  - Thrombolytic Therapy
MH  - Tissue Plasminogen Activator/therapeutic use
MH  - Tomography, X-Ray Computed
MH  - *Travel
MH  - Venous Thrombosis/*diagnosis/drug therapy
PMC - PMC4543850
EDAT- 2012/11/29 06:00
MHDA- 2014/01/22 06:00
PMCR- 2014/11/27
CRDT- 2012/11/29 06:00
PHST- 2012/11/29 06:00 [entrez]
PHST- 2012/11/29 06:00 [pubmed]
PHST- 2014/01/22 06:00 [medline]
PHST- 2014/11/27 00:00 [pmc-release]
AID - bcr-2012-007221 [pii]
AID - 10.1136/bcr-2012-007221 [doi]
PST - epublish
SO  - BMJ Case Rep. 2012 Nov 27;2012:bcr2012007221. doi: 10.1136/bcr-2012-007221.