Abstract
Background. Pulmonary infarction, which is a consequence of pulmonary embolism (PE), has been one of the main problems of clinical medicine for several years due to its prevalence, mortality rate in this condition, and the difficulty of timely diagnosis. PE takes the first place among in-hospital mortality, the diagnosis is often missed, untimely treatment is carried out due to the variety of clinical symptoms. Aim: to consider the aspects of diagnosis, treatment and prevention of the disease in the practice of a general practitioner in the example of a clinical case of PE with pulmonary infarction. Materials and methods. We conducted a retrospective analysis of the results of the examination of a PE with pulmonary infarction patient. We used such methods as medical history taking, objective examination instrumental and laboratory diagnostic methods. Results. We present the case of a patient with chronic cardiovascular pathology who developed severe complications, specifically pulmonary embolism (PE) and infarct pneumonia, due to non-compliance with prescribed therapy and inadequate control by the family doctor. Upon hospitalization, the patient complained of general weakness, shortness of breath with minimal physical exertion, severe pain in the right and left hypochondrium, lower limb edema, and occasional hemoptysis. On physical examination, the patient was in moderate distress, adopting a forced position due to shortness of breath. The skin appeared pale, and there was acrocyanosis of the lips. Auscultation revealed vesicular breath sounds with a rough accentuation in the lower parts of the lungs, predominantly on the right. Tachycardia and oliguria were also noted. Laboratory tests showed elevated levels of erythrocyte sedimentation rate (ESR), fibrinogen, and troponin I. Multislice computed tomography (CT) demonstrated signs of PE in the small branches of the right lung, as well as a focus of infarct pneumonia in segment S8 of the right lung. Timely antithrombotic therapy was initiated, leading to a positive clinical and laboratory response. The patient's condition improved, with the heart rate normalizing to 79 beats per minute. Edema, shortness of breath, and pain intensity significantly decreased. Laboratory parameters also showed positive trends, including a reduction in D-dimer levels to within the normal range. Conclusion. Delayed medical consultation may lead to severe complications such as pulmonary embolism (PE) and infarct-pneumonia. Reliable diagnosis of these conditions requires the use of instrumental methods, with multislice CT being the most informative. Effective treatment of PE includes the early administration of modern anticoagulant agents. Prevention of PE is based on adherence to dietary recommendations, regular medication intake, and continuous follow-up by a family physician