Large hiatal hernia as a risk factor for recurrent pulmonary embolism in a 76-year-old female patient
, 2, 1, 1, 1, 1
Abstract
Introduction: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary
embolism (PE), is a serious public health problem. Each hospitalized patient should be assessed for the risk of
thrombosis. However, it should be noted that in some cases patients may have rare risk factors which may not
be known at the initial assessment stage.
Material and methods: The purpose of this paper was to present a case report of a 76-year-old female
patient with a second episode of PE, who had a rare risk factor in the form of extensive hiatal hernia (HH)
causing pressure on the pulmonary arteries.
Results: A 76-year-old patient was admitted to the Clinic as part of the emergency service due to dyspnoea
that had been increasing for three days and fainting. For approximately a week, the patient stopped taking
previously recommended medications, including anticoagulant treatment initiated due to PE diagnosed two
months earlier. As a result of the diagnostic tests, a second episode of intermediate-risk PE associated with
a massive HH was diagnosed.
Conclusions: A large HH is a rare but important factor that may lead to an increased risk of PE occurrence
due to compression of the pulmonary arteries, especially if it coexists with a significant deepening of thoracic
kyphosis, which is associated with an additional increase in mediastinal tightness.
Keywords: hiatal herniapulmonary embolismvenous thromboembolismthrombosis
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