• J Invasive Cardiol · Dec 2012

    Case Reports

    Massive pulmonary embolism with shock: role of thrombolysis using central venous access.

    • Jayasree Pillarisetti and Kamal Gupta.
    • Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Medical Center and Hospital, Kansas City, KS 66209, USA. jayasreep24@gmail.com
    • J Invasive Cardiol. 2012 Dec 1;24(12):E321-4.

    BackgroundMassive pulmonary embolism (PE) complicated with shock has an extremely high mortality rate with medical treatment. Since access to emergency vascular surgery or endovascular specialists is not readily available in most centers, patients are frequently treated with thrombolytic agents delivered via a peripheral venous access. Patients with shock, however, have poor peripheral perfusion, and peripheral administration of thrombolytic agents may thus not reliably deliver the agent to the embolus, reducing treatment efficacy.ObjectiveThis report discusses the role of thrombolysis administered via central venous access in PE with shock.Case ReportThis report describes the case of a 46-year-old man presenting with new-onset atrial fibrillation, right bundle branch block, and shock from a massive PE. In view of shock, thrombolytics were given via a subclavian central venous catheter. He improved dramatically within 1 hour, with prompt resolution of the shock and the dysrhythmia.

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