Prevalence of long-term right ventricular dysfunction after acute pulmonary embolism: a systematic review and meta-analysis

Wang, Dingyi; Fan, Guohui; Zhang, Xiaomeng; Xi, Linfeng; Chen, Yinong; Li, Aili; Zhai, Zhenguo

doi:10.1016/j.eclinm.2023.102153

Cited by 6 publications

(1 citation statement)

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“…Three PE sequelae can be distinguished: CTEPH, CTEPD without PH and PPEI [1,55,56]. Persistent symptoms and/or right ventricular dysfunction from PPEI occur in about every two to six patients, increasing the risk of re-hospitalization, death, and a lower quality of life [55][56][57][58][59][60][61]. CTEPH and CTEPD without PH typically present as unclear exertional dyspnea after PE [1,62,63].…”

Section: Role Of the Ecg In Pulmonary Embolism Sequalaementioning

confidence: 99%

Electrocardiographic Changes after Endovascular Mechanical Thrombectomy in a Patient with Pulmonary Embolism—A Case Report and Literature Review

Ley,

Messmer,

Vaisnora

et al. 2024

JCM

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Background: Pulmonary embolism (PE) is a common disease with an annual incidence of about 1/1000 persons. About every sixth patient dies within the first 30 days after diagnosis. The electrocardiogram (ECG) is one of the first diagnostic tests performed, and is able to confirm the suspicion of PE with typical electrocardiographic signs. Some ECG signs and their regression are also prognostically relevant. Endovascular mechanical thrombectomy is one option for PE treatment, and aims to relieve right heart strain immediately. The first studies on endovascular mechanical thrombectomy using a dedicated device (FlowTriever System, Inari Medical, Irvine, CA, USA) yielded promising results. Methods: In the following, we report the case of a 66-year-old male patient who presented with New York Heart Association III dyspnea in our emergency department. Among typical clinical and laboratory results, he displayed very impressive electrocardiographic and radiological findings at the time of PE diagnosis. Results: After endovascular mechanical thrombectomy, the patient’s complaints and pulmonary hemodynamics improved remarkably. In contrast, the ECG worsened paradoxically 18 h after intervention. Nevertheless, control echocardiography 4 days after the intervention no longer showed any signs of right heart strain, and dyspnea had disappeared completely. At a 4-month follow-up visit, the patient presented as completely symptom-free with a high quality of life. His ECG and echocardiography were normal and excluded recurrent right heart strain. Conclusions: Overall, the patient benefitted remarkably from endovascular mechanical thrombectomy, resulting in an almost complete resolution of electrocardiographic PE signs at the 4-month follow-up after exhibiting multiple typical electrocardiographic PE signs at time of diagnosis and initial electrocardiographic worsening 18 h post successful intervention.

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