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Lots of interesting abstracts and cases were submitted for TCTAP 2021 Virtual. Below are accepted ones after thoroughly reviewed by our official reviewers. Don’t miss the opportunity to explore your knowledge and interact with authors as well as virtual participants by sharing your opinion!

TCTAP C-101

Presenter

Chayan Singha

Authors

Chayan Singha1

Affiliation

BSMMU, Bangladesh1,
View Study Report
TCTAP C-101
IMAGING AND PHYSIOLOGIC LESION ASSESSMENT - Imaging: Non-Invasive

Role of Echocardiography Where Life is on the Rope©

Chayan Singha1

BSMMU, Bangladesh1,

Clinical Information

Patient initials or Identifier Number

Mr. X of a 65 yrs old gentleman is known case of HTN, DM, APKD and Recently diagnosed covid 19

Relevant Clinical History and Physical Exam

A -65 Yrs. old gentleman is known case of HTN, DM, APKD,& Recently diagnosed case of Covid 19 presented to us with shortness of breath and central chest pain for one day, On exam: he was cyanosed, dyspneic, R/R- 50/min, pulse-120/min, BP-80/50 mm of Hg. Raised JVP, no signs of DVT but peripheries were cold, lungs -BL Crackles on lower lung and heart- NAD.

202011202215079137.mp4

Relevant Test Results Prior to Catheterization

D-dimer-8.9, S. Troponin- 1.2 ng/ml. NT-Pro BNP-1583


Relevant Catheterization Findings

After diagnosing acute massive pulmonary embolism due to covid 19. We promptly treated by thrombolytic and UF heparin drip and pt. was extubated 20 hrs later due to successful thrombolysis. Subsequently, pt. was discharged on the 7th day by NOAC for consecutive 3 months.
20201102_104509.mp4

Interventional Management

Procedural Step

During evaluating our case all of a sudden he underwent cardiac arrest and promptly reverted back by CPR and DC shock. So, he was on mechanical ventilation for maintain his SPO2. His diagnosis was A case of severe covid 19 with acute massive pulmonary embolism with cardiac arrest survivor with cardiogenic shock with H/O HTN, DM, APKD. We promptly started UFH drip, Ionotropes and thrombolytic- inje. Alteplase.About 20 hrs. later he was extubated and discharged on the 7th day with rivaroxaban for 3 months. We had done follow up echo. which showed complete dissolution of pulmonary thrombus.
20201102_104509.mp4

Case Summary

Covid 19 is a global pandemic, which has created a new horror in our life. A significant percentage of patient suffered acute pulmonary embolism despite anticoagulation. Proper diagnosis and early initiation of effective treatment is a great challenge. Bed side echo has a tremendous role for diagnosis, hemodynamic assessment, exclusion of differentials and assess prognosis.

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