Factor Xa inhibition and sPESI failure in intermediate-high-risk pulmonary embolism
We report the case of a 61-year-old man who presented at the Emergency Department (ED), complaining of sudden-onset dyspnea and chest pain after a long flight from Tokyo to Houston. Considering his clinical stability and sPESI 0, enoxaparin 1 mg/kg BID was started for 24 h, and the patient was then considered for early discharge with apixaban 10 mg BID. Direct-factor Xa inhibition did not improve extensive thrombus burden and right ventricular dysfunction despite D-dimer measurement reduction. Because of the treatment failure, we considered thrombolysis.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Alejandro R. Trevino, Luis Perez, Carlos Jerjes-Sanchez, David Rodriguez, Jathniel Panneflek, Claudia Ortiz-Ledesma, Francisco Nevarez, Vicente Jimenez, Felipe Valdes, Eduardo de Obeso Source Type: research