Objective:

To report the emergency management and successful recovery of an 85-year-old female who experienced acute perioperative pulmonary embolism (APE) during anesthesia induction for surgery related to a comminuted intertrochanteric fracture.

Approach:

Key Findings:

• The patient had a profound hypercoagulable state identified prior to anesthesia induction.
• Sudden cardiovascular collapse occurred post-induction, confirmed as massive APE via echocardiography.
• Emergency low-dose thrombolysis (50 mg alteplase) was successfully administered.

Interpretation:

Intraoperative ultrasound and ECG monitoring are crucial for fragile geriatric patients. Low-dose systemic thrombolysis can reverse acute obstructive shock when mechanical options are unavailable.

Limitations:

• The generalizability of low-dose thrombolysis findings requires cautious interpretation due to the specific patient context and the unique circumstances of the case.

Conclusion:

The case highlights the importance of rapid intervention and monitoring in managing APE during anesthesia induction.

Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.