The Effectiveness of Systemic Thrombolysis in the Treatment of Massive Pulmonary Embolism

The article presents a case of timely diagnosis and successful treatment of massive pulmonary embolism in a young man suffering from obesity, hypertension and osteochondrosis of the lumbar spine. The disease was manifested with symptoms of acute respiratory failure, hemodynamics was stable. Laboratory tests revealed an increase in the level of D-dimer and hypercoagulation. Electrocardiographic examination revealed signs of overloading of the right ventricle, and echocardiography revealed pulmonary hypertension of the 2nd degree. Ultrasound examination of the venous system of the lower extremities detected that the cause of the embolism was the migration of a blood clot from a thrombosed femoral vein. The diagnosis was confirmed during computed tomography of the lungs with intravenous contrast. Thrombolytic therapy was performed with alteplase in standard dosages. The patient underwent anticoagulant therapy for 3 months.