One clot after another in COVID-19 patient: diagnostic utility of handheld echocardiogram
Document Type
Article
Publication Title
Oxford medical case reports
Abstract
A 63-year-old woman was admitted with severe respiratory distress requiring mechanical ventilation and shock requiring vasopressor support. She was found to have COVID-19 pneumonia. Focused cardiac ultrasound performed for evaluation of shock was significant for right ventricular dilation and dysfunction with signs of right ventricular pressure overload. Given worsening shock and hypoxemia systemic thrombolysis was administered for presumed massive pulmonary embolism with remarkable improvement of hemodynamics and respiratory failure. In next 24 h patient's neurologic status deteriorated to the point of unresponsiveness. Emergent computed tomography showed multiple ischemic infarcts concerning for embolic etiology. Focused cardiac ultrasound with agitated saline showed large right to left shunt due to a patent foramen ovale. This was confirmed by transesophageal echocardiogram, 5 months later. This case highlights strengths of focused cardiac ultrasound in critical care setting and in patients with COVID-19 when access to other imaging modalities can be limited.
First Page
omaa141
DOI
10.1093/omcr/omaa141
Publication Date
2-1-2021
Recommended Citation
Jeyashanmugaraja, Gini Priyadharshini; Shloknik, Evgeny; Akanya, Deborah Tosin; Stawiarski, Kristin; Winterbottom, Christopher; and Zarich, Stuart, "One clot after another in COVID-19 patient: diagnostic utility of handheld echocardiogram" (2021). Cardiology. 7.
https://scholar.bridgeporthospital.org/cardiology/7
Identifier
33614051 (pubmed); PMC7885150 (pmc); 10.1093/omcr/omaa141 (doi); omaa141 (pii)