両側肺動脈主幹部血栓塞栓症に対して内科治療が有効であった1例

Abstract

A 59-year old man was admitted because of a sudden onset of dyspnea and loss of consciousness. A chest radiograph showed increased lung field tranlucency and enlargement of the pulmonary artery in the hilar region. Enhanced computed tomography revealed large, obstructing thromboemboli in the bilateral main pulmonary arteries. Thrombi had also formed in a deep vein of the left leg. After injection of urokinase and heparin at an early stage, the thromboemboli in the pulmonary arteries and deep vein disappeared. Pulmonary thromboemboli in the bilateral main pulmonary arteries is rare and has a high mortality rate. It is suggested that early diagnosis and thrombolytic therapy could reduce the associated mortality rate.