2017


To access this material please log in or register

Register Authorize
2017/№S3

The case of repeated syncopes in recurrent pulmonary embolism

Vatutin N. T.1, Taradin G. G.1, Kostogryz V. B.2, Orlov A. G.2, Kanisheva I. V.1, Sosedenko E. A.3
1 – M. Gorky Donetsk National Medical University of the Ukraine Ministry of Health Care, Prospekt Iljicha 16, Donetsk 83003, Ukraine
2 – V. K. Gusak Institute of Urgent and Reconstructive Surgery of the Ukrainian National
Academy of Medical Sciences, Leninskij Prospekt 47, Donetsk 83045, Ukraine
3 – Municipal Clinical Hospital #23, Donetsk, Ukraine 83008

Keywords: pulmonary embolism, thromboembolism of pulmonary artery, venous thromboembolism, diagnostics, syncope, clinical manifestations

DOI: 10.18087/cardio.2398

The article provides a case report of recurrent syncopal episodes in a 57-year old male patient. During a three-month period of recurrent syncope, the patient was managed by the family doctor and at pulmonology and cardiology departments for different diagnoses. Due to an uncertainty in diagnosis, the patient was moved to a hospital where he underwent echocardiographic examination and duplex scanning of right leg veins, which detected a 49.3 mm right leg venous thrombus with a free-floating head in the right common femoral vein. Retrospectively, recurrent pulmonary artery thromboembolism was diagnosed. Thrombectomy and ligation of the right superficial artery were performed; an approximately 17 cm long thrombus was removed; the anticoagulant treatment was administered with a beneficial effect.
  1. Ватутин Н. Т. Неотложная кардиология. Донецк; 2011. 236 с [Vatutin N. T. Neotlozhnaya kardiologiya. Doneczk; 2011. 236 s].
  2. Воробьева Н. А., Пономарева И. А. Венозный тромбоэмболизм – мифы и реальность. Трудный Пациент. 2009;7 (6–7):36–42 [Vorob`eva N. A., Ponomareva I. A. Venozny`j tromboe`mbolizm – mify` i real`nost`. Trudny`j Paczient. 2009;7 (6–7):36–42].
  3. Ватутин Н. Т., Калинкина Н. В., Перуева И. А. Тромбоэмболия легочной артерии: современное состояние проблемы. Практическая ангиология. 2011; (2):32–40 [Vatutin N. T., Kalinkina N. V., Perueva I. A. Tromboe`mboliya legochnoj arterii: sovremennoe sostoyanie problemy`. Prakticheskaya angiologiya. 2011;(2):32–40].
  4. Ватутин Н. Т., Калинкина Н. В., Ещенко Е. В., Костогрыз В. Б., Касем С. С. Тромбоэмболия легочной артерии (основные сведения и собственное наблюдение). Серце і судини. 2013; (1):120–123 [Vatutin N. T., Kalinkina N. V., Eshhenko E. V., Kostogry`z V. B., Kasem S. S. Tromboe`mboliya legochnoj arterii (osnovny`e svedeniya i sobstvennoe nablyudenie). Sercze і sudini. 2013; (1):120–123].
  5. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism: the task force for the diagnosis and management of acute pulmonary embolism of the european society of cardiology (ESC) endorsed by the european respiratory society (ERS). European Heart Journal. 2014;35 (43):3033–73. DOI:10.1093/eurheartj/ehu283.
  6. Di Nisio M, van Es N, Büller HR. Deep vein thrombosis and pulmonary embolism. The Lancet. 2016;388 (10063):3060–73. DOI:10.1016/S0140–6736(16)30514–1.
  7. Wexels F, Dahl OE, Pripp AH, Seljeflot I. Thrombin generation in patients with suspected venous thromboembolism. Clinical and Applied Thrombosis/Hemostasis. 2017;23 (5):416–21. DOI:10.1177/1076029617700999.
  8. Wells PS, Anderson DR, Rodger M, Ginsberg JS, Kearon C, Gent M et al. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost. 2000;83 (3):416–20.
  9. Le Gal G, Righini M, Roy P-M, Sanchez O, Aujesky D, Bounameaux H et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med. 2006;144 (3):165–71.
  10. Shen W-K, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD et al. 2017 ACC/AHA/HRS Guideline for the evaluation and management of patients with syncope. Journal of the American College of Cardiology. 2017;70 (5):e39–110. DOI:10.1016/j.jacc.2017.03.003.
  11. Jiménez D, Díaz G, Valle M, Martí D, Escobar C, Vidal R et al. [Prognostic value of syncope in the presentation of pulmonary embolism]. Arch Bronconeumol. 2005;41 (7):385–8.
  12. Iqbal U, Jameel A, Anwar H, Scribani MB, Bischof E, Chaudhary A. Does syncope predict mortality in patients with acute pulmonary embolism? A retrospective review. Journal of clinical medicine research. 2017;9 (6):516–9. DOI:10.14740/jocmr3037w.
  13. Duplyakov D, Kurakina E, Pavlova T, Khokhlunov S, Surkova E. Value of syncope in patients with high-to-intermediate risk pulmonary artery embolism. European Heart Journal: acute cardiovascular care. 2015;4 (4):353–8. DOI:10.1177/2048872614527837.
  14. Prandoni P, Lensing AWA, Prins MH, Ciammaichella M, Perlati M, Mumoli N et al. Prevalence of pulmonary embolism among patients hospitalized for syncope. New England Journal of Medicine. 2016;375 (16):1524–31. DOI:10.1056/NEJMoa1602172.
  15. Keller K, Beule J, Balzer JO, Dippold W. Syncope and collapse in acute pulmonary embolism. The American Journal of Emergency Medicine. 2016;34 (7):1251–7. DOI:10.1016/j.ajem.2016.03.061.
  16. Konstantinides S, Geibel A, Olschewski M, Heinrich F, Grosser K, Rauber K et al. Association between thrombolytic treatment and the prognosis of hemodynamically stable patients with major pulmonary embolism: results of a multicenter registry. Circulation. 1997;96 (3):882–8.
  17. Altınsoy B, Erboy F, Tanrıverdi H, Uygur F, Atalay F, Tor M et al. Syncope as a presentation of acute pulmonary embolism. Therapeutics and Clinical Risk Management. 2016; Volume 12:1023–8. DOI:10.2147/TCRM.S105722.
Vatutin N. T., Taradin G. G., Kostogryz V. B., Orlov A. G., Kanisheva I. V., Sosedenko E. A. The case of repeated syncopes in recurrent pulmonary embolism. Kardiologiia. 2017;57(S3):76–80

To access this material please log in or register

Register Authorize
Ru En