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CLC number: R543

On-line Access: 2014-06-03

Received: 2014-07-30

Revision Accepted: 2014-08-30

Crosschecked: 2014-08-30

Cited: 2

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Citations:  Bibtex RefMan EndNote GB/T7714

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Journal of Zhejiang University SCIENCE B 2014 Vol.15 No.9 P.838-844


Concurrent pulmonary thrombosis with systemic embolism: a case report*

Author(s):  Xiao-jie Xie, Ju-bo Jiang, Jun Jiang, Jian-an Wang

Affiliation(s):  . Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China

Corresponding email(s):   jian_an_wang@yahoo.com

Key Words:  Pulmonary thrombosis, Cerebral infarction, Acute myocardial infarction (AMI), Ventricular aneurysm

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Xiao-jie Xie, Ju-bo Jiang, Jun Jiang, Jian-an Wang. Concurrent pulmonary thrombosis with systemic embolism: a case report[J]. Journal of Zhejiang University Science B, 2014, 15(9): 838-844.

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author="Xiao-jie Xie, Ju-bo Jiang, Jun Jiang, Jian-an Wang",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Concurrent pulmonary thrombosis with systemic embolism: a case report
%A Xiao-jie Xie
%A Ju-bo Jiang
%A Jun Jiang
%A Jian-an Wang
%J Journal of Zhejiang University SCIENCE B
%V 15
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%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1400209

T1 - Concurrent pulmonary thrombosis with systemic embolism: a case report
A1 - Xiao-jie Xie
A1 - Ju-bo Jiang
A1 - Jun Jiang
A1 - Jian-an Wang
J0 - Journal of Zhejiang University Science B
VL - 15
IS - 9
SP - 838
EP - 844
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PB - Zhejiang University Press & Springer
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DOI - 10.1631/jzus.B1400209

Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation therapy should be adopted for patients with arteriovenous embolism. Balancing the risk of ischemia and hemorrhage is especially challenging in these patients in order to achieve an optimal clinical benefit. We report on a 55-year-old female with acute pulmonary embolism (PE), subsequently diagnosed as having acute myocardial infarction (AMI) and a cerebral infarction. Examinations had been carried out, excluding potential arteriovenous shunts, cancer, antiphospholipid syndrome and other common hypercoagulable states. A combination of an anticoagulant drug (rivaroxaban, an Xa inhibitor) and an antiplatelet agent (clopidogrel, an ADP receptor inhibitor) was prescribed with a β-blocker and atorvastatin. The embolus was gradually shrunk during the next 10 months, and then it turned back into expanding. During the 16 months’ follow-up, an aneurysm of left ventricular apex was found through an echocardiogram and an angiotensin-converting enzyme inhibitor was administered. We conclude that combined anticoagulation and antiplatelet therapy significantly relieved the symptoms and improved the prognosis in patients suffering from arteriovenous embolism without any major clinical bleeding events.



Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


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