Mr. X of a 65 yrs old gentleman is known case of HTN, DM, APKD and Recently diagnosed covid 19
A -65 Yrs. old gentleman is known case of HTN, DM, APKD,& Recently diagnosed case of Covid 19 presented to us with shortness of breath and central chest pain for one day, On exam: he was cyanosed, dyspneic, R/R- 50/min, pulse-120/min, BP-80/50 mm of Hg. Raised JVP, no signs of DVT but peripheries were cold, lungs -BL Crackles on lower lung and heart- NAD. 202011202215079137.mp4
After diagnosing acute massive pulmonary embolism due to covid 19. We promptly treated by thrombolytic and UF heparin drip and pt. was extubated 20 hrs later due to successful thrombolysis. Subsequently, pt. was discharged on the 7th day by NOAC for consecutive 3 months. 20201102_104509.mp4
During evaluating our case all of a sudden he underwent cardiac arrest and promptly reverted back by CPR and DC shock. So, he was on mechanical ventilation for maintain his SPO2. His diagnosis was A case of severe covid 19 with acute massive pulmonary embolism with cardiac arrest survivor with cardiogenic shock with H/O HTN, DM, APKD. We promptly started UFH drip, Ionotropes and thrombolytic- inje. Alteplase.About 20 hrs. later he was extubated and discharged on the 7th day with rivaroxaban for 3 months. We had done follow up echo. which showed complete dissolution of pulmonary thrombus. 20201102_104509.mp4
Covid 19 is a global pandemic, which has created a new horror in our life. A significant percentage of patient suffered acute pulmonary embolism despite anticoagulation. Proper diagnosis and early initiation of effective treatment is a great challenge. Bed side echo has a tremendous role for diagnosis, hemodynamic assessment, exclusion of differentials and assess prognosis.