Abstract
Introduction: A massive pulmonary embolism (MPE) has a poor prognosis and high mortality. Thrombolytic therapy is preferred in patients with life-threatening symptoms such as hypotension, cardiogenic shock, and right ventricular failure due to the risk of severe bleeding.
Materials and Methods: This is a retrospective analysis of patients who were hospitalized with the diagnosis of pulmonary embolism (PE) and given thrombolytic therapy in the chest diseases clinic of a tertiary university hospital between January 2008 and November 2013.
Results: The subjects' mean age was 59.54 ± 13.76 years. Fourteen of 39 patients who were treated with thrombolytic therapy were male (35.89%) and 25 (64.10%) were female. The symptoms experienced by the patients included dyspnea in 39 patients, chest pain in 35 patients, hemoptysis in 6 patients, syncope in 13 patients and cough in 10 patients. Risk factors were advanced age (> 60 years) in 19, immobilization in 19, malignancy in 3, major surgery in 11 patients. The in-hospital mortality analysis showed that 32 patients were discharged and 7 patients died. Four patients died from their pulmonary embolism and 3 patients died because of a major bleeding complication.
Conclusions: Pulmonary embolism is a disease that may lead to death within hours secondary to acute right heart failure. Early diagnosis and treatment can be life saving. Thrombolytic therapy has been shown to improve hemodynamic parameters in the early period post-PE. An increased risk of bleeding is one of the most important drawbacks of thrombolytic therapy. Nonetheless, it can be a life-saving therapy in properly selected patients.
- © 2014 ERS
