Pulmonary Thromboembolism in Healthy Woman Taking Oral Contraceptives: Case Report

Abstract

Pulmonary thromboembolism is as a result of complete or partial obstruction of the pulmonary arteries and is a serious cardiopulmonary disease which can be fatal. Pulmonary thrombi most frequently occur in deep femoral veins. Taking oral contraceptives increases the risk of pulmonary thromboembolism. If a patient has a hereditary prothrombic factor, the risk of pulmonary embolism is much more higher. We know that there is an interaction among oral contraceptive drugs, hematological system and cardiovascular system. We here present a 37-year old healthy woman who has been taking oral contraceptives for nearly a year and who came with shortness of breath.

Keywords

• Pulmonary thromboembolism, oral contraceptive, cardiopulmonary disease

Oral Kontraseptif Kullanan Sağlıklı Kadında Pulmoner Tromboemboli: Vaka Sunumu

Öz

Özet

Pulmoner emboli, pulmoner arteryel yatağın tam veya kısmi tıkanması sonucu meydana gelen ve hayatı tehdit edebilen ciddi bir kardiyopulmoner hastalıktır. Akciğere ulaşan trombüsler en sık derin femoral venlerde oluşan ve sonrasında koparak venöz sisteme dahil olan trombüslerdir. Oral kontraseptif kullanımı pulmoner tromboemboli riskini artırır. Eğer hastada kalıtsal protrombik faktör var ise pulmoner emboli riski daha da fazladır. Oral kontraseptif ilaçlarla kardiyovasküler sistem ve hematolojik sistem arasında etkileşim olduğunu bilmekteyiz. Bu olgumuzda daha öncesinde sağlıklı olan ve yaklaşık bir yıldır oral kontraseptif kullanan 37 yaşında nefes darlığıyla başvuran hastayı sunduk.

Anahtar Kelimeler

• Pulmoner tromboemboli, oral kontraseptif, kardiyopulmoner hastalık

Kaynakça

1. Palevsky HL, Kelly MA, Fishman AP. Pulmonary thromboembolic disease. In: Fishman AP, ed. Fishman’s Pulmonary Diseases and Disorders. 3rd ed. New York: Mc Graw-Hill; 1998:1297-329.
2. Wagenvoort CA. Pathology of pulmonary thromboembolism. Chest 1995;107:10-7.
3. Saygıner A. Akciğer embolizmi. İliçin G, Ünal S, Biberoğlu K, Akalın S, Süleymanlar G, eds. Temel İç Hastalıkları. Ankara: Güneş Tıp;1996:538-43.
4. Poulter NR, Chang CL, Farley TM, Meirik O, Marmot MG. Venous thromboembolic disease and combined oral contraceptives: results of international multicentre case-control study. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Lancet, 1995;346(8990):1575-82.
5. Carr BR, Ory H. Estrogen and progestin components of oral contraceptives: relationship to vascular disease. Contraception 1997; 55(5): 267-272.
6. Black A, Francoeur D, Rowe T. Canadian Contraception Consensus. SOGC Clinical Practice Guidelines. J Obstet Gynaecol Can 2004;26(3):219-254.
7. Rosenberg MJ, Meyers A, Roy V. Efficacy, cycle control, and side effects of low and lowerdose oral contraceptives: a randomized trial of 20 mcg and 35 mcg estrogen preparations. Contraception 1999;60(6):321-329.
8. Rosenberg MJ, Waugh MS. Oral contraceptive discontinuation: a prospective evaluation of frequency and reasons. Am J Obstet Gynecol 1998;179(3):577-582.

9. Hylckama V, Helmerhorst F, Vandenbroucke J, Doggen C, Rosendaal F. The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case control study. BMJ 2009;339:b2921 ( doi: http:// dx.doi.org/10.1136/bmj.b2921).
10. Palla A, Petruzelli S, Donnamaria V, Giuntini C. The role of suspicion in the diagnosis of pulmonary embolism. Chest1995;107(suppl 1):21S-24S.
11. Yazışma Adresi / Correspondence Dr. İsmail Arslan Ankara Eğitim ve Araştırma Hastanesi Aile Hekimliği Kliniği e-posta: [e-mail] Geliş Tarihi:18.03.2014 Kabul Tarihi:13.07.2014 23 Ankara Medical Journal, Cilt 14, Ek Sayı 1, 2014