PMID- 32617232
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 12
IP  - 5
DP  - 2020 May 30
TI  - Massive Pulmonary Embolism as a Cause of Cardiac Arrest: Navigating Unknowns in 
      Life After Death.
PG  - e8361
LID - 10.7759/cureus.8361 [doi]
LID - e8361
AB  - Pulmonary embolism (PE) is a common diagnosis with a low associated mortality 
      rate. More critical variants, such as massive PE, also known as fulminant PE, are 
      characterized by severe hemodynamic instability and have a markedly higher 
      mortality rate. These variants can later develop in previously low to 
      intermediate-risk patients and precipitate cardiac arrest within hours of symptom 
      onset. The high mortality rate associated with massive PE is confounded by the 
      difficulty in identifying patients most at risk of decompensating and a lack of 
      clear treatment guidelines. We present the case of a patient at low to 
      intermediate-high risk upon admission, and after failing systemic thrombolysis, 
      decompensated, and went into cardiac arrest. This article serves to reinforce the 
      need to closely monitor these patients due to the insufficiency of prognostic 
      scores to predict decompensation and highlights the need for further research. We 
      advocate the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) as 
      means of stabilization and will discuss various therapeutic alternatives.
CI  - Copyright (c) 2020, Mata et al.
FAU - Mata, Robin
AU  - Mata R
AD  - Internal Medicine, Nova Southeastern University School of Osteopathic Medicine, 
      Fort Lauderdale, USA.
FAU - McDermott, Gabrielle
AU  - McDermott G
AD  - Physical Medicine and Rehabilitation, Memorial Regional Hospital / Nova 
      Southeastern University-Dr. Kiran C. Patel College of Osteopathic Medicine 
      (KPCOM), Hollywood, USA.
FAU - Diaz, Lorenzo
AU  - Diaz L
AD  - Physical Medicine and Rehabilitation, Memorial Regional Hospital / Nova 
      Southeastern University-Dr. Kiran C. Patel College of Osteopathic Medicine 
      (KPCOM), Hollywood, USA.
LA  - eng
PT  - Case Reports
DEP - 20200530
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC7325409
OTO - NOTNLM
OT  - acute pulmonary embolism
OT  - alteplase
OT  - inpatient care
OT  - massive pulmonary embolism
OT  - pert
OT  - pulmonary critical care
OT  - systemic thrombolysis
OT  - thrombectomy
OT  - tpa
OT  - va-ecmo
COIS- The authors have declared that no competing interests exist.
EDAT- 2020/07/04 06:00
MHDA- 2020/07/04 06:01
PMCR- 2020/05/30
CRDT- 2020/07/04 06:00
PHST- 2020/07/04 06:00 [entrez]
PHST- 2020/07/04 06:00 [pubmed]
PHST- 2020/07/04 06:01 [medline]
PHST- 2020/05/30 00:00 [pmc-release]
AID - 10.7759/cureus.8361 [doi]
PST - epublish
SO  - Cureus. 2020 May 30;12(5):e8361. doi: 10.7759/cureus.8361.