{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:39:53Z","timestamp":1767177593624,"version":"build-2238731810"},"update-to":[{"DOI":"10.12688\/f1000research.28311.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000}},{"DOI":"10.12688\/f1000research.28311.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000}}],"reference-count":17,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Pulmonary embolism is a potentially life-threatening condition. Despite advances in diagnostics, lack of consensus and delays in determining the diagnosis of pulmonary embolism are still important problems. We report the diagnosis and management of a 37-year-old man suffering from massive pulmonary embolism, a large protruding thrombus, and dilated cardiomyopathy. Echocardiography showed dilatation of all cardiac chambers, a large protruding thrombus in the right atrium to the inferior vena cava, impaired left and right ventricular systolic function, and global hypokinetic of the left ventricle with eccentric left ventricular hypertrophy. A thoracic computerized tomography scan showed pulmonary embolism with infarction. The patient\u2019s blood pressure was 60\/40 mmHg and heart rate was 110 bpm. The patient was diagnosed with high-risk acute pulmonary embolism. We gave him hemodynamic support and reperfusion therapy with a loading dose of 250,000 units of Streptokinase followed by 100,000 units\/hour for 24 hours. After revascularization, the patient's hemodynamic condition improved. The diagnosis of acute pulmonary embolism is based on clinical symptoms, hemodynamic changes, or radiological examination. Unstable hemodynamic underlies high-risk stratification. Hypotension or shock results from obstruction of the pulmonary artery which causes increased right ventricular afterload and acute right ventricular dysfunction. Reperfusion with thrombolysis therapy could provide good outcomes in this patient. Prolonged anticoagulation should be given to prevent the recurrence of venous thromboembolism.<\/ns3:p>","DOI":"10.12688\/f1000research.28311.3","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T09:30:08Z","timestamp":1616405408000},"page":"13","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Successful revascularization in massive pulmonary embolism with a large protruding thrombus and dilated cardiomyopathy"],"prefix":"10.12688","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5603-9487","authenticated-orcid":false,"given":"Hendri","family":"Susilo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rerdin","family":"Julario","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5180-957X","authenticated-orcid":false,"given":"Citrawati","family":"Dyah Kencono Wungu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"2363-71","DOI":"10.1161\/ATVBAHA.114.304488","article-title":"Thrombosis: A Major Contributor to Global Disease Burden.","volume":"34","author":"G Raskob","year":"2014","journal-title":"Arterioscler Thromb Vasc Biol."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"26-32","DOI":"10.1016\/j.ajem.2009.07.005","article-title":"The role of risk factors in delayed diagnosis of pulmonary embolism.","volume":"29","author":"S Ozsu","year":"2011","journal-title":"Am J Emerg Med."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1182\/blood.V106.11.910.910","article-title":"Estimated Annual Number of Incident and Recurrent, Non-Fatal and Fatal Venous Thromboembolism (VTE) Events in the US.","volume":"106","author":"J Heit","year":"2005","journal-title":"Blood."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"756-64","DOI":"10.1160\/TH07-03-0212","article-title":"Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality.","volume":"98","author":"A Cohen","year":"2007","journal-title":"Thromb Haemost."},{"key":"ref-5","article-title":"Movement of the large protruding thrombus (1)","author":"H Susilo","year":"2020"},{"key":"ref-6","article-title":"Movement of the large protruding thrombus (2)","author":"H Susilo","year":"2020"},{"key":"ref-7","article-title":"Movement of the large protruding thrombus (3)","author":"H Susilo","year":"2020"},{"key":"ref-8","article-title":"Disappearance of large protruding thrombus after revascularization (4)","author":"H Susilo","year":"2020"},{"key":"ref-9","article-title":"Disappearance of large protruding thrombus after revascularization (5)","author":"H Susilo","year":"2020"},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"146-9","DOI":"10.4103\/jcecho.jcecho_64_17","article-title":"Free-Floating Right Heart Thrombus with Acute Massive Pulmonary Embolism: A Case Report and Review of the Literature.","volume":"28","author":"F Charif","year":"2018","journal-title":"J Cardiovasc Echogr."},{"key":"ref-11","doi-asserted-by":"publisher","first-page":"1835-46","DOI":"10.1016\/S0140-6736(11)61904-1","article-title":"Pulmonary embolism and deep vein thrombosis.","volume":"379","author":"S Goldhaber","year":"2012","journal-title":"Lancet."},{"key":"ref-12","first-page":"2380-7","article-title":"Comprehensive analysis of the results of the PIOPED Study. Prospective Investigation of Pulmonary Embolism Diagnosis Study.","volume":"36","author":"D Worsley","year":"1995","journal-title":"J Nucl Med."},{"key":"ref-13","doi-asserted-by":"publisher","first-page":"543-603","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS).","volume":"41","author":"S Konstantinides","year":"2020","journal-title":"Eur Heart J."},{"key":"ref-14","doi-asserted-by":"publisher","first-page":"7S-47S","DOI":"10.1378\/chest.1412S3","article-title":"Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.","volume":"141","author":"G Guyatt","year":"2012","journal-title":"Chest."},{"key":"ref-15","doi-asserted-by":"publisher","first-page":"1287-97","DOI":"10.1056\/NEJMoa1113572","article-title":"Oral rivaroxaban for the treatment of symptomatic pulmonary embolism.","volume":"366","author":"H B\u00fcller","year":"2012","journal-title":"N Engl J Med."},{"key":"ref-16","doi-asserted-by":"publisher","first-page":"169-178","DOI":"10.1007\/s11239-017-1519-8","article-title":"Effectiveness and safety of apixaban therapy in daily-care patients with atrial fibrillation: results from the Dresden NOAC Registry.","volume":"44","author":"S Helmert","year":"2017","journal-title":"J Thromb Thrombolysis."},{"key":"ref-17","doi-asserted-by":"publisher","first-page":"955-62","DOI":"10.1182\/blood-2014-03-563577","article-title":"Rates, management, and outcome of rivaroxaban bleeding in daily care: Results from the Dresden NOAC registry.","volume":"124","author":"J Beyer-Westendorf","year":"2014","journal-title":"Blood."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/10-13\/v3\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/10-13\/v3\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/10-13\/v3\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T11:26:42Z","timestamp":1616498802000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/10-13\/v3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,22]]},"references-count":17,"URL":"https:\/\/doi.org\/10.12688\/f1000research.28311.3","relation":{},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,22]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/10-13\/v3#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.54267.r79576, Henry Sutanto, Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands, 15 Feb 2021, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/10-13\/v2#referee-response-79576","order":0,"name":"referee-response-79576","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.54267.r81266, Dyana Sarvasti, Department of Internal Medicine, Faculty of Medicine, Widya Mandala Catholic University, Surabaya, Indonesia, 16 Mar 2021, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/10-13\/v2#referee-response-81266","order":1,"name":"referee-response-81266","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Citrawati Wungu<\/b>; \n<i>Posted: 17 Mar 2021<\/i>; We have repaired the grammatical errors, written the abbreviations as their meaning, corrected the word &quot;thrombus&quot; in the figures, and&nbsp;added the explanation of the abbreviations in the figures&nbsp;as suggested.","URL":"https:\/\/f1000research.com\/articles\/10-13\/v3#referee-comment-6463","order":2,"name":"referee-comment-6463","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}