World Journal of
Pharmaceutical and Life Sciences

PALPITATIONS AND SYNCOPES: AND IF IT WAS A PULMONARY EMBOLISM

Bodian Malick, Sangaré Zoumana, Dr. Mingou Joseph Salvador*, Yékini Carole Fadila, Aw Fatou, Sarr SA, Jeilany Abdallah, Ndiaye Mouhamadou Bamba, Kane Adama, Diao Maboury, Ba Serigne Abdou

ABSTRACT

Pulmonary embolism is a common condition whose diagnosis can be difficult because of the highly variable clinical picture. Doppler echocardiography, beyond the evaluation of haemodynamic repercussions on the right ventricle, may reveal intracavitary thrombi. If the adverse prognosis of these situations is well established, their management is far from consensual. . We report the case of a 53-year-old patient who was referred to us for a brief, repetitive, self-limiting loss of consciousness, spontaneously resolving, without biting of the tongue or loss of urine. He reported intense palpitations. The attending physician offered a tilt test. Physical examination noted a B2 brust at the pulmonary focus. An episode of unconsciousness occurred before the installation on the tilt test table and allowed to note a blood pressure impregnable per-critical. Trans thoracic Doppler echocardiography showed dilatation of the right cavities with moderate impairment of systolic function of the right ventricle. There were numerous mobile thrombus in the prolapsing right atrium in the right ventricle in diastole. There was also a thrombus adhering to the apex of the right ventricle. Fibrinolysis was undertaken with streptokinase and this treatment was relayed by anticoagulation. The immediate evolution was favorable with a disappearance of syncope. Doppler ultrasound of the lower limbs revealed left popliteal thrombosis. Control Doppler echocardiography performed on the third day showed no more thrombus; the right ventricle was of normal size and its systolic function was correct.

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