Acute massıve pulmonary embolism assocıated wıth olanzapıne

Am J Emerg Med. 2017 Oct;35(10):1582.e5-1582.e7. doi: 10.1016/j.ajem.2017.07.026. Epub 2017 Jul 6.

Abstract

Treatment with low-potency anti-psychotic agents is an important risk factor in the development of pulmonary embolism (PE). We report a case of 74years old female patient receiving olanzapine for psychotic depression admitted to the emergency service with the complaints of chest pain and shortness of breath. She had tachypnea, hypotension and tachycardia. Arterial blood gas analysis showed hypoxemia-hypocapnia and D-dimer level was high. Computed tomographic pulmonary angiography (CTPA) demonstrated pulmonary embolism in both main pulmonary arteries, through lobar and segmental branches. Tissue plasminogen activator (t-PA) was administered in intensive care unit. As the only possible risk factor for PE was olanzapine, olanzapine treatment was terminated with pyschiatry consultation. During the 12-month follow-up of the patient; malignancy was not observed. Diagnosis and prevention of PE are the important goals to reduce morbidity and mortality in subjects receiving olanzapine.

Keywords: Olanzapine; Pulmonary embolism; Thrombolytic treatment.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged
  • Anticoagulants / therapeutic use
  • Benzodiazepines / adverse effects*
  • Benzodiazepines / therapeutic use
  • Computed Tomography Angiography
  • Depression / drug therapy
  • Female
  • Humans
  • Olanzapine
  • Pulmonary Embolism / chemically induced*
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / drug therapy
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Severity of Illness Index
  • Warfarin / therapeutic use*

Substances

  • Anticoagulants
  • Serotonin Uptake Inhibitors
  • Benzodiazepines
  • Warfarin
  • Olanzapine