Pulmonary embolism as a complication in a patient with COVID-19 infection

Abstract

INTRODUCTION: The most common cardiovascular complications during COVID-19 disease are pulmonary thromboembolism. AIM: The importance of early recognition of pulmonary embolism and initiation of adequate therapeutic procedures in prehospital conditions in a patient with confirmed coronavirus infection has been shown. Methodology: Case report based on medical records. CASE REPORT: The ambulance team intervened in a coronavirus-positive patient due to sudden problems in the form of dyspnea and cyanosis in the neck area. During the examination, the patient is conscious, oriented, has difficulty pronouncing words, has pale and sweaty facial skin, cyanosis of the chest, neck and fingers without peripheral oedema, he is dyspnoic with shallow breaths, SpO2 51%, tachycardia (pulse 135/min.), and is normotensive (TA: 120/60 mm Hg). According to clinical condition of the patient, it is suspected that it is a pulmonary embolism. The patient was placed on non-invasive mechanical ventilation in CPAP mode (PEEP 5, FiO2, 100% O2), accompanied by the opening of a venous line and the administration of a Heparin 5000 i.j. intravenous bolus. The oxygen flow was 15 L/min during the ambulance transport. The patient was continuously monitored for ECG, blood pressure, pulse, and SpO2. He was urgently transferred to the Covid Hospital in Mišeluk to the Intensive Care Unit, where a pulmonary embolism was confirmed and therapy was continued. On the fifth day of hospitalisation, a fatal outcome occurs. CONCLUSION: The anamnestic data on COVID-19 disease and the typical clinical picture facilitated the diagnosis of pulmonary embolism in prehospital conditions.