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The patient developed progressive right heart failure with associated hepatic and renal failure requiring dialysis. Definitive therapy is surgical valve replacement but this was contraindicated in this patient due to the severe thrombocytopenia. B CONCLUSIONS: b Our patient illustrates the difficulty in determining the etiology of the thrombocytopenia. [Extracted from the article]

A computed tomography (CT) scan of the chest showed a large amount of air within the right ventricle and pulmonary arteries, consistent with massive air embolism. B DISCUSSION: b Venous air embolism can obstruct the right ventricular outflow tract or occlude the pulmonary microvasculature causing hypoxia and endothelial damage. Immediate resuscitation includes mechanical ventilation with high FiO2 and proper patient positioning; definite treatment is HBO. [Extracted from the article]