An unusual occurrence: a case of venous thromboembolism in pregnancy associated with heterotaxy syndrome

BACKGROUND: Heterotaxy is a relatively uncommon congenital anomaly that is usually diagnosed incidentally on imaging studies in adults. We present an unusual case of venous thromboembolism in a 26 year old pregnant female with Heterotaxy syndrome. CASE PRESENTATION: A 26 year-old pregnant female at...

Descripción completa

Detalles Bibliográficos
Autores principales: Epperla, Narendranath, Peterson, Erika, Foy, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457096/
https://www.ncbi.nlm.nih.gov/pubmed/26052441
http://dx.doi.org/10.1186/s12878-015-0025-5
_version_ 1782374936261689344
author Epperla, Narendranath
Peterson, Erika
Foy, Patrick
author_facet Epperla, Narendranath
Peterson, Erika
Foy, Patrick
author_sort Epperla, Narendranath
collection PubMed
description BACKGROUND: Heterotaxy is a relatively uncommon congenital anomaly that is usually diagnosed incidentally on imaging studies in adults. We present an unusual case of venous thromboembolism in a 26 year old pregnant female with Heterotaxy syndrome. CASE PRESENTATION: A 26 year-old pregnant female at 13 weeks gestation suffered cardiac arrest with successful cardiac resuscitation and return of spontaneous circulation. The cardiac arrest was secondary to massive pulmonary embolism requiring thrombolytic therapy and stabilization of hemodynamics. She had extensive evaluation to determine the etiology for the pulmonary embolism and was noted to have an anatomic variation consistent with heterotaxy syndrome on imaging studies. After thrombolysis the patient was treated with UFH and then switched to enoxaparin without complication until 25 weeks of gestation when she experienced worsening abdominal pain with associated headaches, lightheadedness and elevated blood pressures needing elective induction of labor. The infant died shortly after delivery. The anticoagulation was continued for additional 3 months and she was subsequently placed on low dose aspirin to prevent recurrent venous thromboembolic episodes. She is currently stable on low dose aspirin and is into her third year after the venous thromboembolism without any recurrence. CONCLUSION: To our knowledge, this is the first reported case of venous thromboembolism in pregnancy associated with heterotaxy syndrome. A discussion on pathophysiology of venous thromboembolism in pregnancy and heterotaxy syndrome has been undertaken along with treatment approach in such situations.
format Online
Article
Text
id pubmed-4457096
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-44570962015-06-06 An unusual occurrence: a case of venous thromboembolism in pregnancy associated with heterotaxy syndrome Epperla, Narendranath Peterson, Erika Foy, Patrick BMC Hematol Case Report BACKGROUND: Heterotaxy is a relatively uncommon congenital anomaly that is usually diagnosed incidentally on imaging studies in adults. We present an unusual case of venous thromboembolism in a 26 year old pregnant female with Heterotaxy syndrome. CASE PRESENTATION: A 26 year-old pregnant female at 13 weeks gestation suffered cardiac arrest with successful cardiac resuscitation and return of spontaneous circulation. The cardiac arrest was secondary to massive pulmonary embolism requiring thrombolytic therapy and stabilization of hemodynamics. She had extensive evaluation to determine the etiology for the pulmonary embolism and was noted to have an anatomic variation consistent with heterotaxy syndrome on imaging studies. After thrombolysis the patient was treated with UFH and then switched to enoxaparin without complication until 25 weeks of gestation when she experienced worsening abdominal pain with associated headaches, lightheadedness and elevated blood pressures needing elective induction of labor. The infant died shortly after delivery. The anticoagulation was continued for additional 3 months and she was subsequently placed on low dose aspirin to prevent recurrent venous thromboembolic episodes. She is currently stable on low dose aspirin and is into her third year after the venous thromboembolism without any recurrence. CONCLUSION: To our knowledge, this is the first reported case of venous thromboembolism in pregnancy associated with heterotaxy syndrome. A discussion on pathophysiology of venous thromboembolism in pregnancy and heterotaxy syndrome has been undertaken along with treatment approach in such situations. BioMed Central 2015-05-12 /pmc/articles/PMC4457096/ /pubmed/26052441 http://dx.doi.org/10.1186/s12878-015-0025-5 Text en © Epperla et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Epperla, Narendranath
Peterson, Erika
Foy, Patrick
An unusual occurrence: a case of venous thromboembolism in pregnancy associated with heterotaxy syndrome
title An unusual occurrence: a case of venous thromboembolism in pregnancy associated with heterotaxy syndrome
title_full An unusual occurrence: a case of venous thromboembolism in pregnancy associated with heterotaxy syndrome
title_fullStr An unusual occurrence: a case of venous thromboembolism in pregnancy associated with heterotaxy syndrome
title_full_unstemmed An unusual occurrence: a case of venous thromboembolism in pregnancy associated with heterotaxy syndrome
title_short An unusual occurrence: a case of venous thromboembolism in pregnancy associated with heterotaxy syndrome
title_sort unusual occurrence: a case of venous thromboembolism in pregnancy associated with heterotaxy syndrome
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457096/
https://www.ncbi.nlm.nih.gov/pubmed/26052441
http://dx.doi.org/10.1186/s12878-015-0025-5
work_keys_str_mv AT epperlanarendranath anunusualoccurrenceacaseofvenousthromboembolisminpregnancyassociatedwithheterotaxysyndrome
AT petersonerika anunusualoccurrenceacaseofvenousthromboembolisminpregnancyassociatedwithheterotaxysyndrome
AT foypatrick anunusualoccurrenceacaseofvenousthromboembolisminpregnancyassociatedwithheterotaxysyndrome
AT epperlanarendranath unusualoccurrenceacaseofvenousthromboembolisminpregnancyassociatedwithheterotaxysyndrome
AT petersonerika unusualoccurrenceacaseofvenousthromboembolisminpregnancyassociatedwithheterotaxysyndrome
AT foypatrick unusualoccurrenceacaseofvenousthromboembolisminpregnancyassociatedwithheterotaxysyndrome