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Fulminante Lungenembolie bei einer jungen Frau

A young woman with fulminant pulmonary embolism

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Zusammenfassung

Wir berichten über eine 24-jährige Frau, die mit Atemnot und Sinustachykardie in unserer Klinik aufgenommen wurde und bei fulminanter Lungenembolie unmittelbar nach Diagnosesicherung im CT unter Einschluss einer Hochdosisthrombolyse mit einem rekombinanten Gewebeplasminogenaktivator über 30 min reanimiert werden musste. Als Risikofaktor wurde neben dem Gebrauch eines lokalen hormonellen Kontrazeptivums (NuvaRing®) eine Resistenz gegen aktiviertes Protein C (Faktor-V-Leiden-Mutation) ermittelt. Nach Einstellung auf eine orale Antikoagulation konnte die Patientin 8 Tage später kreislaufstabil und ohne neurologisches Defizit entlassen werden.

Abstract

We describe the case of a 24-year-old woman who was admitted to the emergency department with dyspnea and sinus tachycardia. The suspected diagnosis of pulmonary embolism was confirmed by computed tomography (CT) scan. The patient lost consciousness soon afterwards and was found to be pulseless. Cardiopulmonary resuscitation was performed and high dosis thrombolysis was given. The patient survived without sequelae and was discharged on oral anticoagulation from the hospital 8 days after the initial admission. In our opinion unknown factor-V Leiden in combination with a local form of hormonal contraception (NuvaRing®) was responsible for the deep venous thrombosis of the left leg and the pulmonary embolism.

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Authors and Affiliations

  1. Klinik für Kardiologie, Pneumologie und Internistische Intensivmedizin, Klinikum München GmbH, Klinikum Neuperlach, Oscar-Maria-Graf-Ring 51, 81737, München, Deutschland

    T. Spinner, M. Segerer, A. Holub, C. Spes & H. Mudra

  2. Praxis für Kardiologie und Angiologie, Rosenheim, Deutschland

    C. Spes

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  1. T. Spinner
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  2. M. Segerer
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  3. A. Holub
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  4. C. Spes
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  5. H. Mudra
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Correspondence to T. Spinner.

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Spinner, T., Segerer, M., Holub, A. et al. Fulminante Lungenembolie bei einer jungen Frau. Internist 53, 985–989 (2012). https://doi.org/10.1007/s00108-012-3082-x

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