Avtor/Urednik		Kariž, Stojan; Grom, Igor; Ambrožič, Jana
Naslov		Pljučna embolija pri bolniku z zvišanim srčnim troponinom I in EKG znaki akutnega miokardnega infarkta spodnje stene
Prevedeni naslov		Pulmonary embolism in a patient with elevated troponin I and ECG signs of acute inferior myocardial infarction
Tip		članek
Vir		In: Bručan A, Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja 8. Zbornik 9. mednarodni simpozij o urgentni medicini; 2002 jun 19-22; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Leto izdaje		2002
Obseg		str. 168-72
Jezik		slo
Abstrakt		Pulmonary embolism and acute coronary syndrome are common diseases that often present with nonspecific and overlapping clinical features. Both can be associated with elevated troponin levels further increasing the potential for misdiagnosis. We report a case of a 77-year-old male patient with chest pain, dyspnea and ECG signs of acute inferior myocardial infarction. Blood analysis revealed elevated levels of cardiac troponin I and CK-MB. During the beginning of thrombolytic therapy with streptokinase we performed an echocardiogram which disclosed an enlarged right ventricle with signs of pressure overload and a mobile thrombus in right atrium. Soon after the start of streptokinase infusion the patient deteriorated with hypotension and apnoe. A short-lived resuscitation was succesful. Since on repeated echocardiogram the thrombus in the right atrium was not found, we decided to continue with thrombolytic therapy using tissue plasminogen activator. Only few minutes after the continuation of thrombolytic therapy the patient deteriorated again with a fall in blood pressure and apnoe. A recurrent attempt of resuscitation was unsuccessful. The autopsy revealed thromboembolism of peripheral branches of both pulmonary arteries, hypertrophy and dilatation of the heart and moderate atherosclerosis of coronary arteries without signs of myocardial infarction.
Deskriptorji		MYOCARDIAL INFARCTION TROPONIN I PULMONARY EMBOLISM AGED