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BMJ Case Reports 2013; doi:10.1136/bcr-2012-007717
  • CASE REPORT

Postpartum patient with congenital patent ductus arteriosus mimicking acute pulmonary embolism

  1. Jau-Cheng Liou2
  1. 1Department of Internal Medicine, Division of Cardiology Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
  2. 2Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
  3. 3Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
  4. 4Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
  5. 5Department of Pharmacology, National Defense Medical Center, Taipei, Taiwan
  6. 6Institute of Biomedical Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
  1. Correspondence to Professor Jau-Cheng Liou, netliou{at}mail.nsysu.edu.tw

Summary

A 25-year-old woman presented with severe dyspnoea at an emergency care unit on her postpartum day 7. Her O2 saturation level was low. Blood tests showed a high blood D-dimer level; echocardiography showed a high pulmonary artery pressure. Initially, heparin was administered for suspicion of pulmonary embolism. After transfer to the intensive care unit, she suffered respiratory failure. A three-dimensional (3D) reconstruction CT angiography then revealed a giant patent ductus arteriosus. Extracorporeal membrane oxygenation was performed owing to low O2 saturation after ventilator use. After 1 month, she died of multiple organ failure. In postpartum patients with congenital heart disease, a diagnosis of pulmonary embolism should be immediately confirmed by 3D reconstruction CT angiography to rule out patent ductus arteriosus.

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