Management of a patient with cardiac arrest: a clinical case of massive pulmonary embolism in an obese young man

Authors

DOI:

https://doi.org/10.22141/2224-0721.18.3.2022.1168

Keywords:

pulmonary embolism, venous thrombosis, high risk, thrombolytic therapy, anticoagulants, obesity

Abstract

Pulmonary artery thromboembolism is one of the few life-threatening conditions. Today, with less mobility due to their professional activities (prolonged sitting at a computer) and social beha­vior, the number of cases of venous thromboembolism has increased. The recommendations of the European Society of Cardiology for pulmonary embolism (2008, 2014, 2019) have become a powerful tool for diagnosing, treating and stratifying the risk of death. Prevention of recurrence of thromboembolic complications and its duration depends on the fact of provocation of pulmonary embolism. Recommendations for the development of thromboembolic complications take into account the presence of heart failure, coronary heart disease, atrial fibrillation (AF), which to some extent blurs the distinction between arterial and venous thrombosis. The fact that the incidence of pulmonary embolism increases with age is indisputable, but in contrast to atherothrombosis, venous thrombosis occurs much earlier, in the younger population. Thus, venous thrombosis is somewhat “youn­ger” than arterial. Regarding gender differences, it is more common in men with age, and women tend to “rejuvenate”. Contraceptives play an important role in this, the risks of venous thromboembolism are pregnancy and childbirth. Although less influential in the development of venous thromboembolism and pulmonary embolism are bed rest (more than three days), immobilization in a sitting position (long flight, car trip), old age, in real clinical practice should not be neglec­ted laparoscopic surgery and concomitant conditions — obesity, diabetes mellitus, hypertension and varicose veins. At the slightest suspicion of pulmonary embolism, it is important for the physician to consider the above factors. A clear algorithm for diagnosis and timely treatment will ensure the effectiveness of such patients and the process of their recovery. In recent years, obesity at the angle of low-intensity inflammation began to be considered involved in the processes of increased thrombosis. Although certain mechanisms of thrombosis in obesity have been elucidated, the frequent fatal thrombotic consequences of severe COVID-19 remain unclear, mainly in the category of patients with obesity, carbohydrate metabolism disorders, and diabetes. In this clinical case, the authors demonstrate the total stratification of risk factors, even at first glance insignificant effects of obesity of the first degree, but in combination with varicose veins of the lower extremities, which caused massive pulmonary embolism in young men.

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Published

2022-06-29

How to Cite

Netiazhenko, V., Malchevska, T., Shkala, L., Puzanova, O., & Altunina, N. (2022). Management of a patient with cardiac arrest: a clinical case of massive pulmonary embolism in an obese young man. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), 18(3), 188–192. https://doi.org/10.22141/2224-0721.18.3.2022.1168

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Section

Clinical Case

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