The Clot Thickens: Diagnosing Acute Pulmonary Embolism as a Trigger for Chronic Obstructive Pulmonary Disease Exacerbation in the Setting of Anticoagulation Failure
  • Sameh Saleh
    Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA; Medicine Services, VA North Texas Health Care System, Dallas, TX, USA http://orcid.org/0000-0001-5959-1659
  • Ishak Mansi
    Medicine Services, VA North Texas Health Care System, Dallas, TX, USA; Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA

Keywords

COPD exacerbation, pulmonary embolism, anticoagulation, anticoagulation failure, enoxaparin

Abstract

Chronic obstructive pulmonary disease (COPD) exacerbations are most commonly triggered by infections, but up to 25% of those that require hospitalization are thought to be triggered by acute pulmonary embolism. We present the case of a 71-year-old patient with a history of unprovoked pulmonary embolisms on anticoagulation therapy hospitalized for a COPD exacerbation. The exacerbation was triggered by an acute pulmonary embolism, representing anticoagulation failure.

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References

  • Sethi S, Murphy TF. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med 2008;359(22):2355–2365.
  • Rizkallah J, Man SFP, Sin DD. Prevalence of pulmonary embolism in acute exacerbations of COPD. Chest 2009;135(3):786–793.
  • Le Gal G, Righini M, Roy PM, Sanchez O, Aujesky D, Bounameaux H, et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med 2006;144(3):165.
  • van Es N, Coppens M, Schulman S, Middeldorp S, Büller HR. Direct oral anticoagulants compared with vitamin K antagonists for acute venous thromboembolism: evidence from phase 3 trials. Blood 2014;124(12):1968–1975.
  • Rodger MA, Miranda S, Delluc A, Carrier M. Management of suspected and confirmed recurrent venous thrombosis while on anticoagulant therapy. What next? Thromb Res 2019;180:105–109.
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    Published: 2020-09-23
    Issue: 2020: Vol 7 No 12 (view)


    How to cite:
    1.
    Saleh S, Mansi I. The Clot Thickens: Diagnosing Acute Pulmonary Embolism as a Trigger for Chronic Obstructive Pulmonary Disease Exacerbation in the Setting of Anticoagulation Failure. EJCRIM 2020;7 doi:10.12890/2020_001884.