Disseminated intravascular coagulation – clinical aspects

Introduction: Disseminated intravascular coagulation (DIC) is a complex clinical-morphological syndrome with fulminant evolution, especially in critical states. Treatment refers to the therapy of the underlying con-dition. The cardiovascular system is prematurely affec-ted by the release of cardiovascular substances. The early detection of patients with cardiovascular disease and initiation of drug therapy is accompanied by bene-ficial effects on global cardiovascular risk, with signifi-cant outcomes in reducing mortality and cardiovascu-lar morbidity.

Methods: We present the case of a 67-years-old, male, smoker (25 pack-year), dyslipidemic, obese, a chro-nic consumer of ethanol, with high-level pressure va-lues for about 6 months, therapeutic non-compliant, who suddenly installs confusion syndrome and fever (t=40.8°C). On the ambulance, the confusional state worsens, the patient becomes comatose, unstable he-modynamically requiring reassurance and insertion of the vasoactive support.

Results: Clinical evolution has been on the rise, with a deepening of coma (Glasgow score=3), the increased need for vasoactive support, coagulation disorders (cli-nical and biological), septic shock and multiple organ failure. Computed tomography (CT) examination co-uld not be performed due to hemodynamic instability. Approximately 18 hours after intake, the patient installs cardiorespiratory arrest, ECG – asystole, undetectable blood pressure. Resuscitation maneuvers were initiated, but the patient remains unresponsive, with death being declared. The necropsy revealed: hemorrhagic cerebral infarction extended to the right brain hemi-sphere associated with ventricular flood, stinging and meningo-cerebral edema with haemorrhage, hematic infiltration of punctures disseminated in all organs.

Conclusions: WHO predicts that atherothrombotic disease will remain one of the leading causes of death for the next two decades. Polyvascular atherothrom-botic damage doubles the risk of major events (acute myocardial infarction/stroke/stroke) or hospitalization over a year, compared to single vascular damage. The prognosis of multiple organ failure depends on the ca-use of the dysfunctions and the severity of the lesions.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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