Cas du mois Janvier 2023 - Cardio-oncologie-


Pulmonary cancer ambulatory managed: what about thromboembolic prevention?

50-year-old patient, hypertensive, dyslipidemia, hypothyroid, BMI at 38 Kg/m2 ,

-diagnosed with pulmonary adenocarcinoma with bone metastases.

-Palliative chemotherapy has been indicated with cisplatin (platinum salts)  and ALIMTA (anti-metabolite)

-Two days after the 3rd cure, she had presented a  generalized edematous syndrome  .   No dyspnea or  chest pain.

- blood pressure: 110/80, HR 96 bat/min, No sign of left or right HF, SpO2 94%

-EKG: sinus tachycardia.  LVEF =60%, no RV dilatation

-  Biology: WC at 7800, Hb at 11.8 g/dl, platelets 266 000, Creatinine 54 mmol/l,  D-dimer 2355 ng/ml

Angio CT:  proximal bilateral pulmonary embolism, without signs of severity

apical lung mass. Multiple secondary lung nodules.  Multiple  secondary bone lesions.

Should thromboprophylaxis be prescribed in our patient, when she was managed at home?