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Case Report
 
Successful tenecteplase use in sudden shock from CT-proven massive pulmonary embolism
Jason P. Stopyra1, William P. Bozeman1
1MD, FACEP, Wake Forest University School of Medicine, Department of Emergency Medicine Winston-Salem, NC.

doi:10.5348/ijcri-201516-CR-10477

Address correspondence to:
Jason P. Stopyra
Dept. of Emergency Medicine, Medical Center Blvd
Winston Salem, NC 27157-1089
Phone: 336-716-2076
Fax: 336-716-1705

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How to cite this article
Stopyra JP, Bozeman WP. Successful tenecteplase use in sudden shock from CT-proven massive pulmonary embolism. Int J Case Rep Images 2015;6(2):86–89.


Abstract
Introduction: Emergency, inpatient, and critical care physicians frequently evaluate for and treat patients with deep venous thrombosis (DVT) and pulmonary embolism. While most patients with diagnosed pulmonary embolism remain stable and do not require aggressive therapy, hemodynamic compromise due to pulmonary embolism can occur suddenly and without warning.
Case Report: In the community emergency department fibrinolysis is the only available lifesaving option for massive pulmonary embolism. In this report, we describe a patient who suddenly became profoundly unstable moments after establishing the diagnosis by computed tomography scan. Systemic fibrinolysis was administered using the single bolus agent tenecteplase; the patient stabilized and recovered without bleeding complications, neurologic or cardiovascular deficits.
Conclusion: All physicians, especially those in a community setting who treat patients with venous thromboembolic disease should be familiar with and prepared to give these agents.

Keywords: CT-proven, Fibrinolysis, Pulmonary embolism, Thrombolysis


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Author Contributions
Jason P. Stopyra – Substantial contributions to conception and design, Drafting of article, Revising it critically for important intellectual content, Final approval of the version to be published
William P. Bozeman – Substantial contributions to conception and design, Drafting of article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Jason P. Stopyra et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.